Epidemiology:
Organisms gain access by oral route via contaminated food, water or milk. Humans are true reservoir of S.typhi in nature. The sources of the organism are human situations, faeces of convalescent carriers, and carriers. Organisms stay alive freezing, drying and spread via ice, dust, food & sewage. Maximum situations are seen where the sanitation is sub-optimal. Incidences are more in summer months. There is reduction in typhoid situations where pure drinking water supplies are sustained and efficient sewage disposal is in position.
Figure: Modes of transmission of typhoid fever
Incubation period:
The incubation period of typhoid is generally from 8 to15 days, with broad variations; up to 40 days has been recorded. Long incubation periods tend to pursue infection with small doses of organisms.Onset:
In around 10 percent of patients the onset is abrupt, similar to classical septicemia. Generally, the patient’s illness begins with a feeling of vague malaise and restlessness that might go on for days with no clear presenting picture that explains why the diagnosis might be missed, even by experienced clinicians in endemic regions, especially whenever other febrile diseases are general.
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