Children get affected from various kinds of ailments. Among them typhoid is a prominent one. Typhoid is not only a serious ailment, but when not treated at the right time and with proper medicines, it can become life-threatening. In fact the side effects of typhoid can remain lifelong.

Typhoid fever or typhoid is a kind of bacterial infection, which is caused due to Salmonella Typhi bacteria (S.Typhi). This bacteria is mainly known to cause food poisoning. Poor sanitation, unhygienic conditions etc. are areas from where this bacteria is transmitted. This is the reason typhoid fever is common in developing and underdeveloped nations mostly as these countries lack hygiene, cleanliness and other health parameters. Food and water are the common sources from where the infection mainly takes place.

Causes of Typhoid Fever in Children

Typhoid fever is mainly caused and spread due to poor hygienic habits. Contaminated food and water are the main sources from where typhoid infection gets into the system. When someone is in direct contact with these components by eating the contaminated food or drinking the water, the person is at higher risk of catching the infection. Mentioned below are some ways in which the typhoid bacteria is transferred from one person to another:

• It might happen that a person is affected with the typhoid bacteria, but he might not know that he is a carrier of the disease. In such a case, the person might contaminate the food or water near them and spread the typhoid germ by sneezing, touching or coughing.
• This particular bacteria, the Salmonella Typhi bacteria, which causes typhoid, has the capacity of surviving in water for some days or in any kind of sewage which is dry.
• Human feces is another thing in which large numbers of typhoid bacteria can be found. When the human feces gets in contact with a water body or some water location, there are high chances of contaminating the water body. Various kinds of insects including flies act as carriers and lead to spreading of bacteria from the human feces to the water. When people consume this water by any chance, they can easily get infected with typhoid. Also, there are chances that the water gets in contact with some kind of food supply and the infection is passed on. When this food or water is consumed, there are high chances of typhoid infection.
• It has been seen that almost 3-5% of individuals affected from typhoid become carriers of the disease. This happens because some strains of the typhoid causing bacteria remain in their body only. While some people are short-term carriers of the disease, others carry the germ for quite long time in their body. New outbreaks of typhoid can take place from such carriers.

Symptoms of typhoid in children

The symptoms of typhoid do not appear immediately after the infection takes place. It takes about a week or sometimes even more for the symptoms to surface after the infection. Infact the extent of symptoms also varies – for some children it can be mild; for others it can be quite severe. Usually in children, the effects are sudden. Some of the most prominent symptoms of typhoid in children include:

• Extremely high fever. The fever might start as light and mild, but it rises in the coming few days and refuses to subside in any way. This continuous high fever is the main symptom of typhoid and this might continue for quite long.
• Even if the child is at complete rest and sleeps properly, he/she might feel extreme fatigue and weakness. Infact he/she might be so weak that he/she cannot sit up from bed. Help is needed for getting up from bed or even for sitting.
• The child might complain of a constant and dull headache or some throbbing feeling in the head.
• Chills and shivering throughout the body can be felt.
• Sore throat or some kind of discomfort in the throat.
• Abdominal pain can be felt and in some cases, it seems that the abdomen of the child has distended.
• Excessive weight loss within very short span of time.
• Diarrhea, which can be extremely severe. There might be blood in the stool as well.
• Bleeding from the nose can be seen in many children.
• Complete loss of appetite as the child refuses to eat anything.
• Extreme irritability, with severe mood swings and even aggressiveness. Hallucinations are also quite common.
• Appearances of rashes or on front part of the body or chest in the initial stage of the infection.

Diagnosis of typhoid in children

When the above mentioned signs and symptoms are seen in children, it is recommended not to make delays and take the child to a doctor immediately. The doctor will carry out thorough medical examination of the child and ask the parent about the various signs and symptoms. Medical history of the child is also asked. For proper diagnosis of typhoid fever, blood tests, stool tests and urine tests are also done. Typhoid causing bacteria Salmonella Typhi appears in the test results when the child tests positive for typhoid. Once the diagnosis is confirmed, treatment for the disease can be started.

Treatment of typhoid in children

Mentioned below are some ways in which typhoid in children is treated:

• Antibiotics are recommended which will help in killing the Salmonella Typhi bacteria. The antibiotics take some time to work, but once they start working signs of improvement are noticed within 2-3 days only. It has been seen that with the right course of antibiotic, the child is seen recovering within a span of 7 days.
• Various kinds of antibiotics are proved to be highly effective in the treatment of typhoid in children. Chlorampheicol was a popular one, but it had lots of side effects, hence it was replaced. Currently, acetaminophen has shown to have great results in the treatment of typhoid for children.
• While prescribing the antibiotic, the doctor might want to know the area where the child had visited last or where he lives. This is because the antibiotic is mainly based on the area from where the typhoid infection has been contracted. This might sound strange but it is true that reactions to antibiotics vary for typhoid bacteria from one place to another. The strain of typhoid bacteria is different at different places and the antibiotics vary accordingly.
• Chances of relapse are very common in typhoid fever. This happens inspite of administering the antibiotic course. In such an occurrence, the treatment of typhoid is started again with antibiotics.
• In case typhoid fever gets very serious and complications arise, the course of antibiotic needs to be continued for a long stretch of time. This is done to ensure that no strains of the bacteria are left inside the body of the child.
• There are high chances of dehydration when a child suffers from typhoid. It is recommended to give him/her ample fluids to avoid dehydration. Semi solid, easy-to-digest foods are also recommended so that proper nutrition is got.

How can typhoid be prevented in children?

Typhoid spreads through contaminated food and water and the disease spreads very quickly too. However, you can try and prevent this disease in children with some precautionary steps. Some of them are as follows:

• Vaccinations and immunization – Vaccines for typhoid are available. However, these can only be administered to children who are more than 2 years old. Vaccines for typhoid for children are available in two variants – as injections and as oral vaccine. For children over 6 years, the oral vaccine is preferred; while for children in the age group of 2-5 years are given injections for vaccination. The effectiveness of the vaccine remains for about 3 years or so. Keep a check on the time period when the vaccine was taken and time for expiry. Consult your doctor for further vaccinations.
• Sanitizing water is very important – Water is the main source of typhoid infection in children as well as in adults. Therefore sanitizing water is very important. For children, it is recommended to boil water and make them drink the same. There are many ways of disinfecting the water as well. Infact sanitized water should be used for cooking, washing, brushing teeth and so on. Many doctors recommend drinking bottled water or mineral water. Ask kids to stay away from drinking water from taps directly or from eating ice cubes made from plain water as there might be typhoid germs present in these water sources. Also, while taking bath or washing mouth, water should not be swallowed.
• Avoiding fruits and vegetables which cannot be peeled–Often times fruits and vegetables are sprayed with water to keep them fresh looking. Fruits and vegetables which do not need to be peeled and can be eaten directly might have the germs in the sprayed water. Therefore it is best to choose fruits and vegetables which can be peeled so that chances of contamination are minimized. Also ensure that all foods should be cooked well and thoroughly. Refrain from eating from street vendors.
• Wash hands properly–This is very important for keeping typhoid germs at bay. Use soap and clean water for washing hands thoroughly. Kids should be taught to wash hands thoroughly before and after they eat food and after using the toilet. In case soap and water are not available, using a hand-sanitizer is recommended.