Causes, symptoms and treatment for Enteric fever: Proper hygiene and clean food is the key to prevention

Usually contracted through contaminated food or water, Enteric fever should be treated promptly with antibiotics to prevent severe complications (Image: Canva)

Enteric fever is a serious condition that can affect multiple organs in the body and is caused due to infection by Salmonella typhi (typhoid fever) and S. Paratyphi A, B and C (Paratyphoid fever). If left untreated, it can be fatal.

Usually contracted through contaminated food or water, Enteric fever should be treated promptly with antibiotics to prevent severe complications. The risk factors for the development of typhoid can compromise the body's natural defences against infections, making patients more susceptible to typhoid and other gastrointestinal illnesses.

The risk factors include:

Acidity: Stomach acidity, especially in infants, can be a risk factor as it may reduce the body's ability to kill harmful bacteria, including Salmonella typhi.

Antacids: Excessive intake of antacids can also reduce stomach acidity, potentially increasing the risk of typhoid infection.

Helicobacter pylori: This is responsible for gastritis and may create conditions in the stomach that make it more susceptible to infections like typhoid.

Others: Inflammatory bowel diseases like Crohn's disease, prior gastrointestinal surgery, and high antibiotic intake can harm the intestinal microorganisms (the good gut bacteria).

Once Salmonella typhi (S. typhi), the bacterium responsible for typhoid fever, enters the body through contaminated food or water, it can be captured by immune cells called macrophages. These bacteria travel to your lymphatic system and then enter your bloodstream. Once in the bloodstream, they can spread to critical organs like liver, spleen, and bone marrow, making you sick.

Typhoid fever is often more prevalent in urban areas and tends to affect younger individuals, including children and adolescents. Food handlers and cooks who contract typhoid can become long-term carriers of the bacterium, posing a risk of infection to others through the food they prepare.

A notorious example is "Typhoid Mary," a New York cook who unintentionally caused a typhoid outbreak through her cooking. This highlights the importance of hygiene and proper food handling in preventing the spread of this infectious disease.

After an incubation period of 10-14 days, the effects of infection are visible. The symptoms include a gradually rising "step-ladder" fever accompanied by headache, cough, sweating, chills, muscle and joint pain, and abdominal discomfort. Some people may develop salmon-coloured rashes (rose spots) on their chests. Other symptoms may include nausea, vomiting, nosebleeds (epistaxis), and a slower heart rate (bradycardia).

Untreated typhoid fever can lead to severe complications such as gastrointestinal bleeding, intestinal perforation, and mental disturbances, including delirium, hysteria, and paranoid psychosis.

Here's what you can do to prevent infection by Salmonella type and the perturbing symptoms that follow:

Keep clean: Keeping the surroundings clean and hygienic is vital to prevent the organism from infecting you. Using the right phenyls to clean the floors and avoiding piling up garbage is important. Showering after returning home from a long day out is also advised.

Conscious food choices: Eating foods that are cooked and hot is recommended. It would be best to avoid eateries out in the open and buffets that have not covered the meals. Make sure to adequately clean raw fruits and vegetables and preferably peel them before consumption.

Keep a check on beverages: Remember that you consume beverages available in factory-sealed containers, and do not use ice from food stalls as it may be made of unhygienic water. It is better to drink pasteurised milk, which may be heated before drinking.

Wash your hands regularly: We have all learnt the importance of hand washing the hard way, thanks to COVID-19. Let's continue to follow this practice consistently. Also, Enteric fever has been named so because of the mode of transmission of the organism - you must wash your hands properly before and after a meal and after using the restroom. All the steps of hand-washing must be followed, as recommended by WHO. If soap is unavailable, you may use alcohol-based sanitisers (try not to leave your home without a sanitiser).