Typhoid fever is an acute systemic disease caused by salmonella typhi. It is a condition in whch there is a typical course of temperature, with marked abdominal symptoms consisting of ulceration of the bowels. The fever is of uncertain duration and liable to frequent relapses.

Typhoid fever is an infectious disease and children contract it from those who have had it, or from carriers. The condition is common in tropical countries with poor sanitation and the menace of flies.

Symptoms

It takes from 10 days to two weeks for this disease to develop. The child-patient feels fhilly, tired and weak. He suffers from headache, loss of appetite , followed by backache and either diarrhoea or constipation. Many patients also have bronchitis, so that in the early stages of typhoid, the disease may appear as pneumonia. The temperature rises and remains high for about 10 days to two weeks. It has tendency to rise in the evening and fall in the morning. Skin eruptions tend to appear in the second week and if proper care is not taken, inflammation of the bones and ulceration of the bowels may occur. The loss of appetite is more apparent . The tongue becomes dry and is coated with white patches in the central region of its surface. The fever gradually comes down to normal by the end of the fourth week.

Causes

Poor sanitation is most often responsible for this disease. Contaminated water is the usual source of infection. The next common cause is infected milk. Other foods may also be responsible forthe disease. Sometimes, certain people, known as carriers , may spread the disease. After a patient has recovered from the disease, the bacteria may still survive in the gall-bladder for years, so that the patient becomes a carrier. If such a carrier is employed in preparing or serving food, the infection can spread. In a few cases, flies may bring the germs into the house and contaminate the food. Germs enter the body through the mouth, causing irritation and ulceration of the lower small bowel.

Typhoid fever usually develops in a child who has a great accumulation of toxic waste and other petrefactive material in his intestine, resulting from wrong diet and faulty style of living. The germ of typhoid fever flourishes upon this morbid condition of the intestine. The disease is more common in children who eat much meat or other flesh foods, as it is the nature of such foods to decompose the putrefy readily within the intestines.

Treatment

A complete bed rest and careful nurising is essential for the child-patient. He should be given liquid diet like milk, barley and fruit juices. Orange juice will be especially beneficial. In fact, the exclusive diet of orange juice diluted with warm water can be taken fro first few days of the treatment with highly beneficial results. IN typhoid fever, the digestive power of the body is seriously hampered, and the patient suffers from blood poisoning called toxaemia. The lack of saliva coats his tongue and often destroys his thirst for water as well as his desire for food. The agreeable flavour of orange juice helps greatly in overcoming these drawbacks. It alsogives energy, increases urinary output and promotes body resistance against infections, thereby, hastening recovery. If possible, warm -water enema should be given daily during this period to cleanse the bowels.

Cold compresses may be applied to the head in case the temperature rises above 103 o F. If this method does not succeed, cold pack may be applied to the whole body. The procedure for this pack has been explained in the Appendix.

After the temperature has come down to normal and the tongue has cleared, the child-patient may be given , for further two or three days, fresh fruits and other easily digestible foods. For drinks, unsweetened lemon water or plain water, either hot or cold, may be given. Thereafter, the child-patient may be allowed to gradually embark upon a well-balanced diet according to his age. The emphasis should be on fresh fruits and raw or lightly- cooked vegetables.

Prevention

The disease can be prevented by ensuring a clean water supply, proper disposal of sewage and implementation of anti-fly measures. All drinking water should be either boiled or thoroughly purified. Milk should be pasteurized or boiled. People who handle food should be carefully screened to be sure that they are not carrying the germs of typhoid.