In previous times, epidemics of such a serious infectious disease as typhoid fever, led to the death of thousands of human lives. Thanks to strict sanitary and epidemiological control, outbreaks of this dangerous intestinal infection have not been observed in our country for a long time. However, in African, Asian and South American countries with hot climates, the incidence of typhoid fever is still very high. The ideal habitat for the causative agent of this disease (typhoidal salmonella from the Enterobacteriaceae family) is contaminated water bodies, poorly purified drinking water, improperly stored dairy and meat products, where high temperature air harmful microorganisms begin to actively reproduce. The bacterium is released from feces bacilli carrier and enters the mouth healthy person through dirty hands, food, or common objects (fecal-oral route of infection). To identify this infectious pathogen, laboratory tests of urine, feces, bile are carried out, and a blood test for typhoid fever is also prescribed.
Indications for testing
First of all, typhoid salmonella infects the intestines, then regional (nearby) lymph nodes, after which it penetrates into circulatory system and causes general intoxication of the body. Indications for donating blood to identify this bacterium are high body temperature, headache, depression, weakness, dry tongue, painful sensations in the area of the right hypochondrium, red rashes on the abdomen (roseola), clouding of consciousness. Laboratory blood tests when diagnosing this pathology are carried out without fail, since similar symptoms are also characteristic of pneumonia, malaria, etc.
Hemogram
This term hides a general clinical blood test, which is an integral part of diagnostic procedures any infectious diseases. The presence of typhoid fever may be indicated by the following indicators: the level of leukocytes in the blood is greatly reduced (leukopenia), there are no eosinophils, and the erythrocyte sedimentation rate (ESR) is increased.
Bacteriological research
Next comes the direct detection of the typhoid pathogen (blood culture). For this purpose, venous blood is taken, inoculated on a special nutrient medium and placed in a thermostatic apparatus in which a high temperature is created. Under the influence of heat, entire colonies of bacteria are formed, suitable for microscopic examination. Hemoculture is considered the most accurate early diagnostic method detection of typhoid fever.
Immunological study
Because the the immune system must respond to the introduction of a foreign agent, approximately by the end of the first week of the disease, antigens and antibodies to the infectious pathogen begin to form in the blood. For immunological research, blood serum is separated, in which the titer (level) of antibodies is determined. This analysis is called a reaction passive hemagglutination(RPGA). In a sick person, the antibody titer can be 1:40, and in a recovering person it can reach 1:2000, therefore this study blood serum is carried out every 5 days.
Preparing for the test
In order for the results of general clinical, bacteriological and immunological tests for typhoid fever to be reliable, it is necessary to prepare accordingly for the blood test. If possible, then three days before the procedure it is advisable to stop taking any medicines. Two days before laboratory tests, alcoholic beverages are prohibited. On the day of visiting the blood donation point, you will have to stop eating dairy products, eggs, butter, fried, smoked and spicy foods. One hour before the tests you should refrain from bad habit smoking. All these factors can cause biochemical, metabolic and hormonal changes in the body that can change laboratory parameters.
Blood test for typhoid fever - necessary procedure to make a correct diagnosis, but it is better to prevent this from developing dangerous disease. It is necessary to keep your hands clean, thoroughly wash fruits and vegetables, avoid eating street food, and fight flies - active carriers of this infection. It is especially important to strictly observe sanitary and hygienic rules for workers Food Industry, preschool and medical institutions.
Typhoid fever develops when the Salmonella bacteria enters the body. It can be introduced into the intestines through unwashed food, contaminated water, and neglect of hygiene rules (for example, by simultaneously using towels with a person who is a carrier of the bacteria).
The route of transmission of infection is fecal-oral. Since the clinical picture of the disease does not have specific symptoms, then to confirm the diagnosis it is necessary to conduct a test for typhoid fever, which will help determine the presence of the pathogen in the body.
When to test for typhoid fever
A blood test for typhoid fever can be taken in two cases:
- when a clinical manifestation characteristic of an intestinal infection appears;
- to prevent epidemics (is mandatory analysis when renewing a health certificate).
If a patient goes to the doctor with a complaint about digestive problems and hyperthermia, the doctor, based on the manifestations of the disease, will make an assumption about the development of an intestinal infection. The presence of typhoid fever is indicated by the following patient complaints:
- abdominal pain;
- signs of poisoning (nausea, vomiting, weakness, loss of appetite, hyperthermia);
- problems with stool (constipation, somewhat less commonly diarrhea);
- dehydration (extreme thirst, tongue covered with a white coating, peeling skin);
- formation of roseola is possible (a skin rash appears a week after infection. When you press it, it disappears and then appears again. The number of rashes is from 4 to 25 elements).
Typhoid fever usually occurs as follows. Acute onset of the disease in 30% of cases. Symptoms of poisoning, deterioration of sleep, headache, weakness increase gradually. Body temperature increases over several days and reaches febrile values. Reaction inhibition appears, the stomach is swollen, flatulence and rumbling appear.
After a person has had typhoid fever, he develops a strong immunity to the typhoid bacillus.
The causative agent of typhus in fresh water can remain viable for up to a month, and in agricultural products for up to 10 days; in dairy products it multiplies and accumulates. Houseflies can also transfer the bacteria to food.
The first signs of the disease appear 7–23 days after infection, so it is extremely difficult to determine the exact source. Typhoid fever must be differentiated from tuberculosis, brucellosis, typhus, cholera, plague and other diseases in which the patient experiences fever and intoxication.
What tests are performed
To confirm typhoid fever, laboratory tests are prescribed, which must be carried out before starting antibiotic therapy (taking antibacterial drugs may affect the accuracy of the diagnosis).
For examination, blood, feces, urine, bile, and cerebrospinal fluid can be taken (if a complication is suspected). Depending on the stage of the disease and symptoms, the following tests for typhoid fever may be prescribed.
Serological study
It examines blood plasma. Necessary for the detection of specific antibodies produced by the human immune system. The analysis can be carried out only 4–5 days after infection with typhoid fever, since the body does not synthesize antibodies earlier.
General blood analysis
Assigned to determine quantitative characteristics all blood cells. When infected with typhoid fever, changes normal indicators blood.
Leukopenia occurs (the number of leukocytes decreases), aneosinophilia (eosinophils are absent), and the number of lymphocytes increases, which indicates the presence of infection in the blood.
Also, during typhoid fever, the level of neutrophils, leukocytes synthesized by the body during inflammation, increases, and the number of platelets, which are responsible for blood clotting, decreases.
A detailed blood test is required upon admission to hospital treatment and during therapy in order to monitor the dynamics. For the study, a blood test is taken from a vein or finger.
Blood biochemistry
Detects acute phase proteins and should be carried out before taking an antibiotic. The test requires 5-10 ml of blood from a vein, the results of the study can be found out within 24 hours.
Bacterial culture
There are few bacteria in the blood sample taken, so it is transferred to a nutrient medium (meat peptone broth) and placed in a thermostatic apparatus. Under favorable conditions, the microorganism will begin to form a large colony, which will be suitable for research.
Afterwards, chemical reagents are used and the type of bacteria is determined. A similar test is performed on all patients with hyperthermia, as well as when checking for typhoid fever. Results can be obtained 4-5 days after the analysis, a preliminary answer will be given after 2 days. Tank culture is the most accurate laboratory diagnosis of typhoid fever.
To detect antibodies to typhoid fever, a radioimmune or enzyme immunoassay method is used
RNGA and RPGA
To detect a person who is a carrier of the typhoid bacillus, as well as to monitor the effect of vaccination against typhoid fever, IRHA (indirect hemagglutination reaction) or passive hemagglutination (RPHA) is used. This method helps detect antigens and antibodies using red blood cells that precipitate when they come into contact with the antigen.
Red blood cells on which antigens are adsorbed stick together upon contact with the antibody. An immunological study determines the level of these antibodies. In a person suffering from typhoid fever, it can be at a level of 1:40, and in someone who has overcome the infection it is 1:2000, so diagnostics are carried out at intervals of 5 days to monitor the dynamics.
Bacteriological examination of stool
This analysis is rarely prescribed, since the typhoid bacillus leaves the body only 8–10 days after infection. This method is used to identify people who are carriers of the infection, but are not sick themselves.
Analysis of urine
Typhoid bacteria are detected in urine only 1–1.5 weeks after infection. A urine test may indicate indirect evidence of typhoid fever such as leukocytosis (on initial stage disease, the number of white blood cells increases, and within 7 days drops sharply), leukopenia, increased ESR, aneosinophilia, relative lymphocytosis.
Before collecting urine, the patient must perform hygiene of the external genitalia, then collect the material for analysis in a sterile jar. For diagnosis, 40–50 ml of urine will be sufficient. To test for infection, a sediment is used, which is transferred to a solid nutrient medium.
The possibility of detecting the causative agent of typhoid fever by microbiological methods is directly related to the number of bacteria in the biological fluid and the use antibacterial therapy. A week after infection with Salmonella S. Typhi, serological agglutination tests (RPGA for typhoid fever) give a positive response.
Serological tests are less specific than bacteriological methods, since a positive response may indicate a past infection caused by another species of Salmonella. An additional study after five days helps to monitor the increase in titer, which is characteristic of acute infection.
Bacteria in the blood are found only in sick people; in the urine and feces, the bacteria can be found in both the sick person and the bacteria carrier
Do you need to prepare for the test?
A blood test for typhoid fever should be taken not only by patients with characteristic features diseases, but also those who, when working, encounter large numbers of people or food. This is done to prevent the spread of typhoid fever, since an infected person can long time be a carrier of infection.
Largest quantity The patient excretes bacteria in feces during the period from the first to the fifth week of the disease, and in urine for 2–4 weeks. Every tenth person who has had an infection releases the typhoid bacillus into the external environment for 3 months, and 3–5% of the total number of typhoid patients are chronic carriers of the infection, spreading the bacillus for several years.
When passing and renewing a health certificate, a test for typhoid fever is mandatory. Many people do not know where the blood is taken for testing. To carry out diagnostics, a sample is taken from the patient. venous blood from the area of the elbow bend.
The study is carried out in vitro, which literally means “in vitro”. How long the test takes depends on the workload of the laboratory; at a minimum, the result will be ready in two days. The doctor issuing the referral will clarify how to properly take a test for typhoid fever.
If there are no clarifications, then you should adhere to the following recommendations:
- You need to donate blood on an empty stomach;
- the day before the event, you should not eat too spicy, salty, fatty or smoked foods;
- it is necessary to exclude the intake of weak and strong alcoholic drinks, medications at least three days before donating blood;
- There is no need to change your drinking regime, but it is still better to give up coffee;
- Smoking is not allowed an hour before the test.
To avoid false-positive or false-negative tests, you need to take a responsible approach to donating blood.
If antibodies to typhoid fever are not detected, then this is confirmation that the person is not a carrier of the infection. If symptoms of the disease are present, and the test does not show the presence of a specific protein, then it is possible that the immune response has not yet been formed, since the pathology is at an early stage.
A positive result indicates that the patient has typhoid fever or is a bacteria carrier.
A false positive test result is possible if a bacteria from the genus Salmonella is present in the body, but causes another disease, that is, the microorganism is present and the immune system reacts by producing antibodies. The doctor will indicate what tests to take if you suspect typhoid fever or when checking for bacteria carriers, as well as where it is best to donate biological material.
If typhoid fever occurs in acute form, then the patient will be hospitalized in an infectious diseases hospital. The patient is prescribed antibiotics, diet and bed rest. It is recommended to avoid any overexertion, even when visiting the restroom. Typhoid fever, in the absence of adequate treatment, can lead to toxic shock and perforation of the intestinal mucosa. Therapy lasts from 2 to 4 weeks.
Necessary for accurate identification of the pathogen, it is advisable to undergo diagnostics before starting antibacterial therapy. The disease is dangerous and the carrier of the pathogen not only puts their own health at risk, but also becomes a source of infection for others. Therefore, at the first suspicion of pathology, an urgent visit to the clinic is necessary.
When are tests for typhoid fever prescribed?
The infection develops as a result of the active activity of salmonella. However, the signs are not specific; they are often observed with other diseases of the gastrointestinal tract:
- Emptying disorder. Both constipation and severe diarrhea are possible.
- Gastrointestinal bleeding. There is blood in the stool.
- Nausea and vomiting.
- Insomnia, apathy, weakness, loss of appetite.
- Intense thirst.
- Skin rash.
- Temperature rises up to 40 degrees.
- Pain in the abdomen and right hypochondrium.
- The tongue becomes covered with a gray coating, but the tip is still red.
In severe cases, the clinical picture includes delirium and spatial disorientation.
The Russian Federation provides for mandatory annual examination for typhoid fever for workers in the food industry, hospitals, and child care institutions. It is advisable for tourists returning from exotic countries where pathology is common.
It is easy to isolate the pathogen in the first 2 days. Therefore, you need to go to the hospital at the initial signs.
Where can I submit biomaterial for analysis?
Today, research is carried out in municipal and private laboratories, as it is necessary to obtain a health certificate. Naturally, in paid clinic You will have to pay a small amount for the certificate. But you can get results much faster.
Cost of blood test for typhoid fever
According to statistics:
- Serological diagnostics will require 600–800 rubles.
- General analysis blood will cost 300–400 rubles.
- Bacteriological sowing costs 700–900 rubles.
- Biochemistry in 300–400.
- ELISA and RIF on average 500–800 rub.
Of course, it turns out to be a decent amount, but for an accurate diagnosis it is necessary to compare several types of studies. Deciphering the results helps not only to identify the pathogen, but also to determine the treatment program.
In a municipal clinic, most work on examining blood, urine or stool samples is performed free of charge.
Types of analyzes
Basically, they prefer to take biological materials for study. If typhoid fever is suspected, various laboratory diagnostic methods are used.
General blood analysis
The method is applied first, but does not provide a complete guarantee. Indirect indicators are taken into account - increased ESR, decreased concentration of leukocytes, increased level of lymphocytes, absence of eosinophils. The results help determine the presence of an infection or inflammatory process.
To examine a patient in vitro, in a laboratory setting, it is enough to take a sample from a finger or a venous vessel.
This should be done before using antibacterial therapy. 5–10 ml are required to detect proteins in acute phase, which are produced by the body during typhoid fever.
Serological blood test
You need to give a sample from the capillary. The period is 4–5 days from the moment of infection, when antigens of type O, Vi and H, characteristic of salmonella, are present in the plasma. The study is repeated on the 8th–10th day of the patient’s stay in the inpatient department.
RNHA (indirect hemagglutination reaction)
The RPG method for typhoid fever helps identify antibodies and antigens based on the rate of precipitation of red blood cells. The sampling is done on an empty stomach, as with other examination methods. It is necessary to abstain from food for 8 hours. The material is taken from the ulnar vein.
A positive result is diagnosed with minimal indicators - for O titer 1:200, for Vi 1:80.
RPHA (passive hemagglutination reaction)
The main direction is to search for antibodies present in the serum. This blood test for typhoid fever is carried out at the end of 2 weeks of illness and repeated after 5 days. In the acute form of the pathology, an increase in titers is observed.
The sample is taken from the ulnar vessel on an empty stomach. A positive result corresponds to readings of 1:40 for Vi antibodies and 1:200 for O.
Bacterial culture
There is not enough salmonella in the blood, so the tissue taken for analysis is placed in a nutrient broth and placed in a thermostat. As the microorganism multiplies, it forms colonies. Laboratory research allows you to determine the type of bacteria.
The result is ready in 4–5 days. Of all the methods, bacterial seeding is the most accurate. Helps identify antibiotic agents effective in the case of typhoid fever. Blood and urine are suitable for work; if about a week has passed since the infection, feces can be used.
Immune fluorescence reaction (IFR)
A quick way to identify pathology in initial development. Antibodies pre-labeled with specific substances are injected into the biomaterial. When antigens are present, microscopic examination of the sample reveals a characteristic glow.
Enzyme-linked immunosorbent assay (ELISA)
A highly sensitive method that determines the presence of antibodies and antigens, helping to clarify their concentration. It is important both for diagnosis and for monitoring the dynamics of the patient’s condition.
Bacteriological examination of stool (coproculture)
Most often, blood is taken from the patient for typhoid fever. But after 1–1.5 weeks the pathogen is present in the feces. It is used to identify those who are infected but not sick.
Bacteriological examination of urine (urinoculture)
8–10 days after infection, the pathogen can be detected in urine. In this case, leukocytosis is noted - an increase in the concentration of white cells in the initial stage of the disease and sharp drop indicator in a week.
To ensure the reliability of the analysis, careful preparation is required: you need to stock up on a sterile container and wash the external genitalia. It is enough to collect only 40–50 ml of liquid.
Bacteriological examination of bile (biculture)
The analysis is used if about 2 weeks have passed since the onset of infection. By this time, salmonella disappears from the blood serum, but spreads into other fluids.
Sometimes a bone marrow puncture is taken for testing. The technique is complex, but reliable, since the presence of pathogens of other pathologies is excluded.
How are the tests done?
In order for the diagnosis to be as accurate as possible, it is necessary to prepare in advance for collecting tissue samples:
- For 72 hours, it is advisable not to take any pharmacological agents, especially antibiotics. Otherwise, you must inform your doctor about the type of drug, time of administration, and dosage.
- It is optimal to donate blood in the morning from 8 to 11.
- In the evening they refuse dinner. The day before the analysis, stop consuming alcohol, fried foods, fatty foods, hot spices, dairy products and eggs.
- No smoking for several hours before collection.
It's better to refrain from physical activity, be less nervous, since even these factors can influence the biochemical composition of the material.
How to read test results?
With typhoid fever, there is an increased level of leukocytes in the first 2 days and a decrease in the level thereafter. At the same time it is observed:
- Increase in lymphocyte concentration.
- Increase in platelets.
- High ESR.
After the serological analysis, a certificate is issued containing the verdict. When “positive” the number of antibodies is given.
Does a “negative” result on the form always indicate the absence of a disease?
Does not necessarily mean that the person does not have the pathogen. Characteristic protein compounds sometimes appear in the blood later, so when the patient is admitted to the hospital, they are not detected at first. Then spend additional examination in a few days.
The absence of antibodies often indicates that the patient was sick, but managed to recover.
What does a “positive” test result indicate?
This verdict means 2 options:
- The disease is in the acute phase.
- Presence of inactive salmonella.
Carriers of the pathogen are 3–4% of people who have had typhoid fever. There are risks of infecting others.
Which doctor should I contact?
At severe symptoms it is necessary to ensure prompt admission of the patient to the hospital. But sometimes a person independently visits a medical facility, complaining of signs of poisoning. In this case, it is better to go to an appointment with an infectious disease specialist, but even an experienced therapist will suspect clinical picture typhoid fever.
Conclusion
The disease is easily transmitted by personal contact, with food and household items. To protect yourself and your loved ones, it is advisable to perform all recommended tests at the first symptoms.
Typhoid fever– spicy infection, which affects the intestines and its lymph nodes. The disease is accompanied by an enlarged liver and spleen, severe intoxication with high fever and clouding of consciousness.
Although the incidence of the disease has decreased over the past hundred years, the problem still remains very relevant. Every year, about 20 million people worldwide become infected with typhoid fever, and 800 thousand die from this disease. People get sick more often in developing countries, where there is a lack of drinking water, poor sanitation and street food trading flourishes. Therefore, tourists who travel to Central Asia, Africa or South America you should be extremely careful.
It is especially dangerous to swim in bodies of water that may be contaminated with sewage and to buy ready-made meals in markets. The highest risk is associated with dairy and meat products, in which the bacteria begins to actively multiply at a temperature of +18 C.
In Russia, thanks to sanitary control, typhoid fever was almost completely eliminated. But in last years a new danger has arisen. Migrants who come to work and our tourists bring Salmonella typhoid from other countries. One sick person can cause infection to many people, especially if he works in the food industry.
You can become infected with typhoid fever from a sick person and from a bacteria carrier who feels completely healthy. The route of transmission is fecal-oral. This means that the bacterium is released from the intestines of a sick person and enters the mouth of a healthy person through food, drinking water, dirty hands or household items.
Large outbreaks and epidemics occur in the summer-autumn period. At high temperatures, the typhoid bacillus multiplies quickly. In addition, flies contribute to its spread.
Sensitivity to the bacterium that causes typhoid fever is high and people of any age can become infected. But according to statistics, children and young people under 30 get sick more often. This is due to the fact that they are more active: they travel more often and eat outside the home.
The causative agent of typhoid fever
The causative agent of this dangerous disease – salmonella typhoid , which belongs to the Enterobacteriaceae family. In appearance, it resembles a short stick with rounded ends. Its shell is densely covered with flagella, which enable the bacterium to actively move.Typhoid fever is distinguished from other diseases by the following symptoms:
- heat
- skin pale and dry
- enlarged dry tongue, coated in the center and clean around the edges
- soreness and rumbling under the right rib
- slight rash in the form of red spots in the upper abdomen and lower chest (appears on day 8-9)
- reduction in heart rate at high temperatures
- signs of intoxication: weakness, lethargy, depression, lethargy, headache
General clinical tests
- Hemogram or clinical (general) blood test. Determines the amount of all elements that make up blood. With typhoid fever the following changes appear:
- moderate leukocytosis - in the first days of the disease, the number of leukocytes increases slightly and the ratio of their types changes. but over the course of a week their number decreases sharply.
- leukopenia – low number of white blood cells
- aneosinophilia – absence of eosinophils in the blood
- relative lymphocytosis - an increase in the percentage of lymphocytes compared to all other leukocytes.
- increased ESR - erythrocyte sedimentation rate increases, but not significantly
- General urine analysis. Urine examination in the laboratory. Laboratory assistant studying physical and chemical characteristics and examines the sediment under a microscope. With typhoid fever, the following is found in the urine:
- red blood cells
- cylinders
For laboratory diagnostics, blood, urine, bile and feces are taken. They are inoculated on nutrient media and placed in a thermostat, where the temperature is constantly maintained at 37 C. If the tests contain typhoid bacteria, they form colonies that can be examined under a microscope. Bacteria in the blood can only be found in sick people, but in feces and urine, salmonella can be found in both a sick person and a carrier of the bacteria.
- Hemoculture– isolation of Salmonella typhoid from the blood. This is the earliest and exact method diagnostics Bacteria appear in the blood during the incubation period and remain until the end of the disease. To detect them, blood (10 ml) is taken from the antecubital vein and inoculated on Rappoport’s liquid nutrient medium. A preliminary result can be obtained on the second day, but the entire study lasts 4 days.
- Coproculture– isolation of typhoid bacteria from feces. Salmonella is found in the intestinal contents from 8-10 days of illness. In this case, solid nutrient media are used.
- Urine culture– determination of typhoid bacteria in urine. It is examined no earlier than on the 7-10th day of illness.
- Bile culture– to study bile, a probe is inserted into small intestine. Bile is collected in sterile tubes and cultured. This study is carried out after recovery.
- Bone marrow culture– a sample is taken during a puncture in the second or third week of illness. It is performed if there is a suspicion that typhoid fever has severely damaged the bone marrow.
Serological research methods
Starting from the second week, special antigens appear in the blood. These are particles of the membrane and flagella of typhoid Salmonella. They can be identified using studies based on immune responses. For analysis, blood is taken from a finger and the serum is separated from it.
- Vidal reaction– determines whether there are O- and H-antigens in the venous blood serum. After interacting with special substances, cells containing particles of typhoid bacteria stick together and precipitate. A positive result can occur not only in the patient, but also in a person who has recovered from the disease, a carrier, or after vaccination. To know for sure that bacteria are multiplying in the blood, the reaction is carried out several times. In case of illness, the titer (level) of antibodies is 1:200 and is constantly increasing.
- Passive hemagglutination reaction (RPHA with cysteine)– the blood serum of a sick person sticks together (aglutenizes) red blood cells coated with antigens. This study also needs to be carried out several times to see if the antibody titer increases. In a sick person it is 1:40 and can increase 3 times. The first analysis is taken on day 5, and then as needed at intervals of 5 days. Vi- and H-antibodies may be elevated in convalescents and carriers.
Treatment of typhoid fever
A patient with typhoid fever is hospitalized in infectious diseases department. You will have to spend more than a month in the hospital. During treatment, strict bed rest must be observed. This will help avoid intestinal rupture and internal bleeding. It is very important not to lift heavy objects or strain, even when going to the toilet. Treatment of typhoid fever proceeds in several directions at once.
Fighting infection
In order to destroy typhoid salmonella, antibiotics are used. Prescribe Levomycetin or Ampicillin in the form of tablets or intramuscularly 4 times a day for a month.At severe forms a combination of antibiotics Ampicillin and Gentamicin is used. Or new generation drugs Azithromycin, Ciprofloxacin.
If antibiotics do not work or are poorly tolerated, then antimicrobial drugs of other groups are prescribed: Biseptol, Bactrim, Septrim, Cotrimoxazole. They are taken 2 tablets 2 times a day. Course 3-4 weeks.
Fighting intoxication and dehydration
You need to drink more to “flush” the toxin from the body, or as doctors say, “detoxify.” The amount of liquid you drink should be at least 2.5-3 liters per day. If this is not enough, then enterosorbents are prescribed. These drugs adsorb (take in) toxins and gases in the intestines. For this purpose, Enterodes, Polyphepan, White coal, Smectu.In case of moderate condition, it is necessary to cleanse not only the intestines, but also the blood. To do this, glucose-saline solutions are administered intravenously so that toxins are eliminated faster by the kidneys. The drugs used are: Lactasol, Kvartasol, Acesol, 5% glucose solution. They are prescribed up to 1.5 liters per day.
If, despite all efforts, intoxication intensifies, then Prednisolone tablets are prescribed for 5 days.
Oxygen therapy helps fight intoxication well. Oxygen is administered through catheters into the nose or a special oxygen pressure chamber is used.
If medications do not help, and the condition continues to worsen over three days, then a blood transfusion is given.
Improvement of general condition
During illness, the bone marrow does not produce enough white blood cells, which provide immunity. To enhance their production and speed up the healing process of ulcers in the intestines, the drugs Methyluracil and Pentoxyl are prescribed. They are taken in tablets after meals. Improve work small capillaries The angioprotector Ascorutin helps to normalize metabolism and blood circulation.
Tincture of ginseng, Schisandra chinensis or Eleutherococcus improves general state, gives strength and improves tone nervous system. Natural herbal preparations are used together with a complex of vitamins: A, B, C, E.
Diet for typhoid fever
For typhoid fever, gentle nutrition is necessary - diet No. 4. Food should not linger in the intestines, irritate it, or cause excessive bile secretion. Doctors recommend dishes that are steamed, rubbed through a sieve, or chopped in a blender. Food should be warm (20-50 C) and washed down with plenty of water. | Authorized Products | Prohibited Products |
| Yesterday's bread | Fresh baked goods |
| Acidophilus milk, three-day kefir, fresh cottage cheese | Alcohol |
| Eggs 1 per day, soft-boiled or scrambled | Pearl barley, millet, barley grits |
| Beef, veal, fish, boiled, stewed or steamed | Fat and fried foods |
| Meat soufflé, steam cutlets, homemade pate | Pork, lamb, duck, goose |
| Vegetables in the form of purees and puddings | Coffee with milk, carbonated drinks |
| Fruits and berries in the form of jelly and mousse | Canned and smoked foods |
| Finely chopped young greens | Fresh vegetables and fruits |
| Sugar, jam | Mustard, horseradish, ketchup, hot spices |
| Puree porridge: buckwheat, oatmeal | Ice cream and confectionery with cream |
| Soups on low-fat broth with cereals and meatballs | Pickles and marinades |
| Olive, sunflower, butter | |
| Tea, cocoa with a little milk, compotes, fresh fruit juices diluted half with water |
You need to eat food 5-6 times a day, in small portions. You cannot convey or experience the feeling of hunger for a long time.
After discharge from the hospital (6-7 weeks of illness), the menu can be gradually expanded. Do not immediately lean on prohibited smoked and fatty dishes. Try small portions of new foods for 7-10 days.
Folk remedies to combat typhoid fever
Some plants have strong bactericidal properties. Therefore in folk medicine they were used as a preventative measure to avoid contracting typhoid fever. Garlic and calamus have proven themselves best. Garlic was eaten and carried with you constantly. Calamus rhizomes were washed, peeled and chewed raw. To treat typhoid fever during epidemics, decoctions of black currant or rose hips, as well as coffee with lemon were often used.
Infusions medicinal herbs help speed up the healing of ulcers in the intestines and cleanse the blood of toxins. Pour 1 tablespoon of burnet roots into a glass hot water and boil for half an hour. Take a tablespoon every 2-3 hours.
Pour 1 tablespoon of St. John's wort herb with a glass of boiling water and leave in a thermos for 1 hour. Drink in small sips throughout the day.
Prepare a mixture of centaury, sage and chamomile herbs. Pour 1 tablespoon of the mixture into a glass of boiling water, leave for 30 minutes and strain. Drink a teaspoon 7-8 times a day.
Folk remedies can be an addition to the treatment prescribed by an infectious disease doctor. But remember, you should not try to overcome the disease on your own. During the treatment of typhoid fever, antibiotics are indispensable.
You can be discharged from the hospital no earlier than a month after the onset of the disease or 21 days after the temperature drops below 37 C. Before discharge, stool and urine samples are taken 3 times. If Salmonella typhoid fever is not detected in the discharge, the patient is sent home.
Typhoid fever has the insidious property of “returning.” This repeated development of the disease is called relapse. In order not to miss the new development of bacteria in the body and carriage, after discharge the patient will have to frequently communicate with doctors and undergo tests.
For the first two months, examinations are carried out once a week. 10 days after discharge you will need to test feces and urine 5 times with an interval of 1-2 days. In the future, you will be able to visit the clinic much less often. After 4 months, it is necessary to take a bile and blood test for the reaction of RPHA with cysteine. If the result is negative and no traces of bacteria are detected, the person will be removed from the register.
Prevention of typhoid fever
Inoculation or vaccine against typhoid fever
IN Lately Antibiotics do not kill some types of typhoid bacteria. Treating the disease has become more difficult and expensive. Therefore, it is advisable for those who are at risk to get vaccinated, which will provide immunity. Vaccination will help prevent you from becoming infected when typhoid salmonella enters your body. If a person does get sick, the illness will be mild. Recovery will occur in 7-14 days, not 4-6 weeks.
Who needs to be vaccinated?
Since children become infected more often, they need vaccination more often. Therefore, in areas where cases of the disease often occur (25 patients per 100,000 population), children aged 5-19 years are vaccinated. Vaccination is also recommended for people at risk. For example, family members where there is a patient and medical workers who encounter this infection.
In our country, general compulsory vaccination is carried out only during epidemics. In other cases, doctors recommend, but do not force, vaccination against typhoid fever.
In recent years, tourists who are planning to visit Asia, South America and Africa have also been vaccinated against typhoid fever. You may not be allowed into countries that are dangerous for typhoid fever without a vaccination certificate. You can clarify this issue with tour operators. The vaccination must be done no later than 1-2 weeks before departure so that immunity has time to form. It helps protect travelers and their families and prevent the spread of this disease in Russia.
How effective are typhoid fever vaccinations?
Efficiency varies slightly among different manufacturers, but is approximately the same. It is 60-75%. This does not mean that the vaccine has no effect at all on the remaining 25-40% of people. If they get sick, it will be more mild form.
Remember that the vaccine does not guarantee against infection. Therefore, even if you were vaccinated before your trip, you will still have to take precautions.
What vaccines are used?
| Vaccine and manufacturer | Basis of the drug | Introduction Features |
| VIANVAK Gritvak, Russia | A liquid vaccine that contains purified and neutralized polysaccharides from the shell of Salmonella typhoid. | Administered subcutaneously to children over 3 years of age and adults. One injection provides immunity for 3 years. Side effects rarely occur. 1-3% of people may develop a fever and redness at the injection site. |
| TIFIVAK – dry alcohol vaccine St. Petersburg Research Institute of Vaccines and Serums, Russia | Powder for preparing a solution. Contains particles of Salmonella typhoid shell. | Administered subcutaneously to children over 5 years of age and adults. Children 2-5 years old with doctor's permission. One administration provides immunity for at least 2-3 years. Side effects rarely occur. In 1-5% of cases there may be thickening and redness at the injection site. |
| TIFIM VI Sanofi Pasteur, France | Solution for subcutaneous or intramuscular injection. Contains polysaccharides from the membrane of the bacterium that causes typhoid fever. | An injection under the skin of the shoulder or into a muscle is given to adults and children after 5 years. A single administration is enough to form immunity for 3 years. Side effects: in rare cases, a slight rise in temperature and painful compaction at the injection site. |
Hygiene
Prevention of typhoid fever comes down to identifying and treating people who are carriers of salmonella. The second direction is to exclude routes of transmission of infection. For this purpose, the sanitary and epidemiological station monitors the purity of drinking water and sewage. Workers involved in food preparation are tested for the presence of typhoid bacteria. But each of us must take care of our own health. Especially in countries where typhoid fever is common. Follow basic safety rules:
- drink only store-bought water
- don't buy food on the streets
- if there is no other choice, buy dishes that have been boiled/fried, and not salads or desserts with cream
- wash your hands after using the toilet and before eating
- do not swim in open bodies of water where sewerage may enter
Description
Determination method RPGA using complex salmonellosis, Vi- and O9 - group salmonellosis diagnosticum with treatment with unithiol in one of the reactions.
Material under study Blood serum
Home visit available
A serological test used in the diagnosis of typhoid fever. Typhoid fever is a severe systemic infectious disease characterized by prolonged increasing fever, abdominal pain, loss of appetite, symptoms of general intoxication, and persistent bacteremia. The pathogen, entering through the intestinal mucosa, penetrates through phagocytosis into the mononuclear phagocytes of the liver, spleen, lymph nodes and Peyer's patches. As a result of phagocytosis by S. typhi, for the most part, do not die, but remain in the mononuclear phagocytes of the reticuloendothelial system during the incubation period and multiply, then entering the blood circulation system. Expressiveness clinical manifestations infections vary. If left untreated, the disease is potentially life-threatening due to the possibility of developing a number of complications, including intestinal bleeding or intestinal perforation due to necrosis of Peyer's patches. In children under 2 years of age, the disease is usually milder. The only source of infection is humans (mainly chronic carriers). Mechanism of transmission may be related to consumption food products, milk, water contaminated with feces, or transmission of infection by contaminated hands. Incubation period illness - from 3 days to 4 weeks or more (on average - 2 weeks). Relapses of typhoid fever with resumption of symptoms after improvement of the condition are possible (8 - 12%). From 2 to 5% of those who recover become chronic carriers. Clinical diagnosis typhoid fever may be difficult. Unconditional laboratory confirmation of the diagnosis is the isolation of typhoid bacilli during serial blood cultures (starting from the first week of the disease) or stool in the second week (see). The detectability of the pathogen by microbiological methods depends on the concentration of the pathogen in the material and the effect of antibiotic therapy. By the second week they become positive results serological agglutination tests, which include the RPGA test for antibodies to S. typhi. Serological tests are inferior in specificity to bacteriological methods because positive reaction they may be due to a previous infection and, in some cases, cross-reactions with other types of Salmonella. It is informative to repeat the study with an interval of 5 days to observe the increase in titers, which characterizes an acute infection.
Literature
- World Health Organization: Background document: the diagnosis, treatment, and prevention of typhoid fever. Geneva, Switzerland: 2003.
- Infectious diseases in children. Ed. D. Murray. M. Praktika, 2006. 928 p.
- Regulatory documents of the Ministry of Health.
Preparation
Indications for use
- In combination with microbiological tests for the diagnosis of typhoid fever ( differential diagnosis gastroenteritis in children; fever of unknown etiology with relative bradycardia, abdominal pain, loss of appetite, general malaise in adults).
- Clinical observation of patients who have had typhoid fever.
- Identification of infection carriers, sanitary and epidemiological studies.
Interpretation of results
Interpretation of research results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. The doctor makes an accurate diagnosis using the results this survey, as well as the necessary information from other sources: medical history, results of other examinations, etc.
Units of measurement in the INVITRO laboratory: semi-quantitative test, units of measurement - titers. In the absence of antibodies, the answer is “negative”; if they are detected, the answer is “positive” with the final titer given. Diagnostic values credits:
- age over 1 year: with complex salmonellosis diagnosticum - 1:200, Vi-diagnosticum - 1:40, O9-diagnosticum - 1:200;
- children under 1 year: with complex salmonellosis diagnosticum - 1:100, Vi-diagnosticum - 1:20, O9-diagnosticum - 1:100.
- acute infection;
- past infection;
- chronic carriage;
- rarely - false positive results due to cross reactions (including other types of salmonella).
- absence of infection;
- early stage diseases;
- long-term periods after recovery.
