Last post we dove into the structure and basic knowledge about Salmonella typhi. It was also stated that S. typhi is spread through what is known as the fecal-oral route.
Before the introduction of antibiotics, Typhoid Fever was fatal in about 10% of people exposed to the bacteria. Most of the fatal cases involved those in crowded cities with poor sanitation, and those with compromised and underdeveloped immune systems. This is due to the fact that S. typhi lives in an infected person’s abdominal lymph nodes and spleen. The fecal-oral route refers to the transmission style, typically S. typhi will travel from the fecal matter of an infected person to a shared water source. The contaminated water would then become the bridge of infection to another individual often through the water used in cooking.
It was long considered to be an infection that only affected areas stricken with poverty, whereas wealthy communities usually had a much better sanitation system, making infection of Typhoid Fever quite rare in those areas.
Negative reactions usually begin after the 10-14 day incubation period after the bacteria penetrate the intestinal wall. First comes headache, fever, and sleeplessness while the bacteria multiplies in the lymphoid tissue. Shortly after, the bacteria contaminate the bloodstream where diarrhea or constipation tend to begin, often (but not always) along with a rash of small red spots. In some cases when the immune system is already compromised the fever leads to death not long after.
A difficult element to Typhoid Fever, is that though many become infected, not everyone has the same reaction. Some individuals do not have the same severe reactions to the bacteria, or recover after a short time. This however does not mean that they are free of the infection. Individuals who have contracted the disease continue to carry the bacteria in their intestines for weeks after illness subsides. Some people continue to unknowingly carry it for many years, and the bacteria is still being excreted through their fecal matter. Any transient or long-term carrier can easily infect others if proper hygiene is not practiced.
One unfortunate case of an unaware carrier is that of Mary Mallon, but after an unfortunate series of events she was given a much more commonly known nickname. Next post will dive more into the bitter story of Typhoid Mary.
Sources Cited:
The Editors of Encyclopædia Britannica. (2017). Typhoid Mary. Encyclopædia Britannica, inc.
Brooks, J. (1996). The sad and tragic life of Typhoid Mary. CMAJ: Canadian Medical Association Journal, 154(6), 915–916.
Marineli, F., Tsoucalas, G., Karamanou, M., & Androutsos, G. (2013). Mary Mallon (1869-1938) and the history of typhoid fever. Annals of Gastroenterology : Quarterly Publication of the Hellenic Society of Gastroenterology, 26(2), 132–134.