10th September, 2019
PRESS RELEASE,
SERIOUS TYPHOID FEVER REBOUNDS DUE TO INCREASING DOMESTIC
POLLUTION SUSPECTED, FG-MELSA
Typhoid fever (Enteric fever) is a gastrointestinal infection caused by the bacterium
Salmonella typhimurium (S. typhi). The World Health Organisation (WHO) estimates the
global typhoid fever disease burden at 11-20 million cases annually, and between 128,000
and 161,000 people die from it every year. Similarly, Ghana is not immune to the burden
of typhoid fever and its associated complications. A research conducted across the country
by the Kintampo Health College (Disease Control Students) late in 2017 indicated that
about 5million people were infected with Typhoid Fever of which about 60 thousand deaths
were recorded.
TRANSMISSION
Surprisingly, no animal carries this disease. Transmission is always human to human
through the faecal-oral route where an infected or asymptomatic individual (who does not
exhibit symptoms) with poor hand or body hygiene passes the infection to another person
when handling food/water or direct contact with the faeces of an infected person. S. typhi
enters through the mouth and spends 1 to 3 weeks in the intestine multiplying. After this,
it makes its way through the intestine wall and into the bloodstream. From the bloodstream,
it spreads into other tissues and organs. The immune system of the host can do little to fight
back because S. typhi can live within the host's cells, safe from the immune system.
Paratyphoid fever, a similar illness but less likely to be fatal, is caused by Salmonella
enterica paratyphi A, B, and C.
RISKS
Urbanization and climate change have the potential to increase the global burden of
typhoid. It is higher in overcrowded populations in cities that lack access to safe water and
inadequate sanitation systems. Poor communities and vulnerable groups including children
are at highest risk. In 2016, the Disease Control Unit of the Ghana Health Service
conducted a study which indicates that the outbreak of Typhoid Fever in the overcrowded
cities such as Accra, Kumasi, Takoradi and the urban areas is as a result of filth and the
rural areas that do not have pipe borne water and boreholes but rely on the streams and
river water has increased from 9.5% to 13.6%. Out of this about 0.9% do not make it to
enjoy life.
SYMPTOMS
Symptoms normally begins between 1 to 3 weeks after exposure to the bacteria. Depending
on the severity of the infection, symptoms can range from mild to severe. It is characterized
by extreme fatigue and increasing fever.
Other symptoms can include: Rarely, symptoms might include:
• Weakness • Confusion
• Abdominal pain • Diarrhoea
• Headaches • Vomiting
Severe symptoms may include intestinal haemorrhage or perforation.
DIAGNOSIS
Analysis samples of blood, stool or urine.
Testing a sample of bone marrow is a more accurate way of diagnosing typhoid fever but
rarely used.
PREVENTION
Furthermore, proper body hygiene and only eating well cooked foods can help prevent and
control typhoid fever. Always use the mantra Boil it, Cook it, Peel it, or Forget it!
VACCINATION
Two vaccines have been used for many years:
• An injectable vaccine based on the purified antigen for people aged over 2 years.
• A live attenuated oral vaccine in capsule formulation for people aged over 5 years.
A new typhoid conjugate vaccine, with longer lasting immunity, was pre-qualified by
WHO in December 2017 for use in children from the age of 6 months.
TREATMENT
Treatable by a medical professional. With treatment, fewer than 4 in 100 cases are fatal. If
untreated, around 1 in 5 cases of typhoid can be fatal.
ELIMINATION APPROACH
Even when the symptoms of typhoid have passed, it is still possible to be carrying the
bacteria, meaning carriers (asymptomatic people) can spread it to others through their
faeces. This makes it difficult to stamp out the disease, because carriers whose symptoms
have passed may be less careful when washing food or interacting with others eventually
spreading the disease to them.