Typhoid Fever

Typhoid fever, also known as enteric fever, is a potentially fatal multi-systemic infection with Salmonella enterica (serovar Typhi). Typhoid fever does not have a non-human host and is transmitted orally via food or beverages handled by carriers, hand-to-mouth contact e.g. after using a contaminated toilet, and contact with contaminated sewage water or shellfish.

Typhoid symptoms included fever, malaise, diffuse abdominal pain and constipation. When left untreated it can rapidly progress to delirium, obtundation, intestinal hemorrhage, bowel perforation, and death. A small percentage of infected individuals become asymptomatic carriers who shed the bacteria with their stool or urine, often for the duration of their life.

Diagnostic testing is essential for the confirmation of typhoid fever, but the protean manifestations and the severity of the disease make it a real diagnostic challenge. Only blood and bone marrow culture can provide a definite diagnosis. As few medical facilities are able to perform bacterial culture the diagnosis often relies only on clinical symptoms or the Widal test. However, the Widal test has a low sensitivity and specificity, and is not recommended by international guidelines.

If a patient presents with unexplained symptoms consistent with typhoid fever antibiotic treatment should be initiated immediately. Treatment should not be delayed for confirmation by bacterial culture, since prompt treatment can drastically reduce the risk of complications and fatalities. The MondialDx Typhoid Fever Human IgM LFA provides a simple means of detecting specific IgM antibodies which gradually increase during the first week of the disease, and is well-suited for use as a point-of-care test where laboratory testing is not available.

Literature

• Pastoor et al. Simple, rapid, and affordable point-of-care test for the serodiagnosis of typhoid fever. Diagn Microbiol Infect Dis 61: 129-134 (2008)