A serious disease caused by Bacillus typhosus, it is spread mainly by contamination of water, milk, or food with sewage. Human carriers excrete the organisms in the faces/urine, and if proper hygiene and sanitation are lacking, contamination of water and food will result. It, therefore, generally occurs during calamities when adequate sanitation is lacking. It lasts for 10-14 days.

Symptoms & Signs

(a) The onset is gradual with slowly rising fever reaching a maximum of 102°-104° F by the end of the week.

(b) Usual signs of a severe fever, frontal headache, epitasis, and marked weakness and fatigue.

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(c) Slow pulse.

(d) Abdominal discomfort, generally constipation but diarrhea may occur.

(c) By the end of the first week the patient appears severely ill and is in a state of physical and menial fatigue, has a dry mouth and hot skin; and on the seventh day the characteristic rash called rose spots occurs.

(f) In the second and third weeks the patient continues severely ill.

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(g) In severe cases patient may relapse into the typhoid state, with delirium, extreme prostration and toxemia.

(h) Steady improvement starts by the end of the third week. Guard against relapse.

Complications

(a) Intestinal Hemorrhage.

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(b) Intestinal Perforation

(c) Meteorism

(d) Acute Myocarditis.

(e) Bronchopneumonia.

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(f) Acute Cholecystitis.

(g) Parotitis.

(h) Thrombophlebitis.

(i) Arthritis.

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Treatment

(a) Isolation procedure, particular attention to disposal of stools and urine. All linens and bedding must be soaked in suitable disinfectant before giving for washing. Separate utensils, which should be boiled after use.

(b) General Nursing and care.

(c) Diet consisting of milk, eggs beaten up in milk or lightly boiled, custard, jelly etc, adequate fluids and citrus fruit for vitamin C.

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(d) Specific treatment consisting of chloramphenicol, which reduces general toxaemia and helps, reduce temperature.