It may come in the guise of food poisoning…….a tummy ache, watery diarrhoea and feeling under the weather.
Several days pass but the fever lingers and the signs and symptoms of the gastrontestinal disturbance continue.
That’s the time to suspect typhoid, for data collected by the Epidemiology Unit indicates that although districts such as Jaffna have had high “notified cases” of typhoid, Colombo too seems to be showing an increasing trend.
In the first nine months of this year, 125 typhoid cases have been notified by the Medical Officers of Health in the Colombo district, almost all from state hospitals. Colombo district, has come in second when compared to Jaffna with 487 cases. Nuwara Eliya has taken up third place with 107 cases.
Typhoid is closely linked to food and water sanitation, MediScene understands, a disease which can also spread due to poor hand-washing.
Caused by the bacterium, Salmonella typhi, the incubation period of this disease is between 8-14 days after which there is a manifestation of symptoms including a stomach-ache with a watery diarrhoeal discharge, vomiting and fever.
Sometimes, there may be not be loose motions or increased frequency of motions but constipation, says Consultant Epidemiologist Dr. Ranjith Batuwanthudawe, pointing out that an indicator may be fever over several days or fever of unknown origin.
“Then typhoid, an infectious disease spread through the faeco-oral route must be suspected,” he stresses.
Salmonella typhi lives only in humans and those with typhoid fever carry the bacteria in their bloodstream and intestinal (food) tract, MediScene learns. Some could very well be carriers without any manifestation of the symptoms.
Those ill with typhoid or carriers shed the bacteria in their stools and if food or drink is handled by them without washing hands thoroughly with soap after using the toilet, the disease will be passed on to others, according to Dr. Batuwanthudawe.
The other way the infection could spread is when sewage contaminated with bacteria gets into water used for drinking or washing food, he says.
When the bacteria enter the body through food or water, they multiply and spread into the blood stream causing fever and other symptoms.
Famous not spared
Typhoid has stricken many famous people including scientist Charles Darwin, the Father of Evolution; author Louisa May Alcott of ‘Little Women’ fame; and Mary Todd Lincoln, the wife of American President Abraham Lincoln who abolished slavery in the US.
In fact, Wilbur Wright who with his brother Orville, built and flew the first airplane, died of typhoid in 1912.
Meanwhile, Mary Mallon, a cook in America had the dubious reputation of not only being a carrier but also infecting 53 people with typhoid, causing the death of three.
Known as ‘Typhoid Mary’ she had to be forcibly quarantined for 26 years by the health authorities as she continued to handle food, despite many warnings not to do so.
Avoid risky food, is the advice of Dr. Batuwanthudawe, who explains that as far as possible you should boil, cook or peel any food that you eat.
Be wary of ice, he says, for if you are not sure whether it is water frozen after boiling, then don’t take it. When eating out, consume food that is hot and steaming.
Most importantly, wash your hands with soap and water frequently and always before handling any food or water and after using the toilet.
When buying from outside, he urges people to select packeted food to ensure minimal handling. Citing the case of string hoppers, he says it is better to buy those already in packets. Then they have most probably been handled only by the person who has made them. therwise, from kitchen to boutique, many people would be touching them.
The chances of the person making the string hoppers washing his/her hands would be more than the person who would be handling them at a small food outlet, he says.