They are called "Salmonella typhi" and "Salmonella enteridis" and are always on top of the list of common suspects when an epidemic breaks out. The pathogens of typhus abdominalis and the weakened form paratyphoid are most fond of feces - where hygenic conditions leave much to be desired, typhus and paratyphus can then spread. The disease is transmitted through feces-contaminated foods and drinks: regular hand washing with clean water is therefore the best way to avoid infection.
Typhus: Diseases become less common
About 17 million people develop typhoid fever each year, of which around 600, 000 die. In the industrialized nations typhus has become rather rare. Of the permanent excretors who acquired their disease during the typhus outbreaks directly after the Second World War and in the fifties, only a few live. Especially from countries with poor hygienic and sanitary conditions typhoid diseases are reported frequently and repeatedly.
Be careful when traveling abroad
80 to 90 percent of all typhoid and paratyphoid cases in Germany today are now being imported from travel regions with inadequate hygiene standards, according to travel medicine researchers. These include Pakistan, India, Thailand, Indonesia, Egypt, Turkey and Morocco. It is estimated that one in 30, 000 long-distance travelers imports typhoid fever. The problem is the increasing antibiotic resistance of the pathogen, which makes successful treatment difficult.
Symptoms and course of typhoid fever
Typhus (Greek typhous haze, fog, dizziness) and paratyphoid fever are bacterial infectious diseases caused by salmonella. It is a severe general infection with a high fever around 40 degrees Celsius, which runs for about three weeks. The fever can last longer. In addition to the fever, the typical initial symptoms include severe headaches. There are also diarrhea, drowsiness and a swollen spleen or liver.
Because the symptoms of the disease are relatively nonspecific, typhoid fever is often recognized late. Complications such as intestinal bleeding or pulmonary typhoid fever can make the disease fatal. About two to five percent of typhoid and paratyphoid patients, after undergoing disease, become so-called "chronic" excreted individuals, meaning they excrete the disease in their stools for weeks after the disease and remain infectious for their future lives.
However, not everyone who takes in typhoid bacteria will have to get sick. The onset of the disease depends on the infection dose and the general health of the patient. This constellation also applies to other Salmonella diseases, which are frequently observed in the summer months to epidemic diarrheal diseases, especially in facilities with commercial kitchens.
Treatment of typhoid fever
In the first and often in the second week of illness, the pathogens in the blood can be detected. However, the results of the blood cultures are available at the earliest after 48 hours, so that patients with suspected typhus or paratyphoid must be immediately isolated because the pathogens can already be eliminated during this phase. From the second week of illness, the pathogens can also be detected in the stool, and in the further course of the disease high antibody levels in the patient's serum can be detected.
Typhus: vaccinate to prevent
Typhoid fever and paratyphoid fever can be treated with antibiotics; in addition, high levels of fluid and electrolyte loss usually have to be compensated for by diarrhea and vomiting. Without treatment with antibiotics, about 10 to 15 percent of the patients die, with treatment about one to two percent. Who plans a long-distance travel, should be vaccinated against typhoid fever. This is not only true for trekking or adventure vacationers: even package tourists can be infected by contaminated food in the hotel with the pathogen.
The vaccine can be given as a dose or as an injection. Both vaccines can be used for both adults and children over the age of 2 years. The typhoid vaccine can be given at the same time as other vaccinations. The swallowing vaccines contain essentially harmless living typhoid bacteria.
For the vaccine to be fully effective, malaria prophylaxis, laxatives or antibiotics should not be taken until three days after completion of the complete typhoid immunization. As three capsules are taken at intervals of two days during the oral vaccination, vaccination planning should be timely and proactive, so as not to jeopardize the vaccination success of these and other vaccines.
Do not vaccinate: pregnant women and children under two years
Booster injections are recommended after three years, and more often after consultation with the doctor, if you stay in a dangerous area. Anyone who suffers from an acute infection should postpone vaccination until the infection dies down. Children under two and pregnant women should refrain from vaccination and travel. During breast-feeding, a dose of oral vaccine can be given because salmonella does not pass into breast milk.