Typhoid Fever disease are also called typhus or types in the Indonesian language, is a disease caused by the bacterium Salmonella enterica, particularly derivatives of Salmonella Typhi primarily affects the digestive tract. Typhoid fever is an acute infectious disease that is always there in the community (endemic) in Indonesia, ranging from toddler age, children and adults.
According to dr. Arlin Algerina, SpA, of Bintaro International Hospital, in Indonesia, estimated between 800 - 100,000 people were exposed to typhus or typhoid fever throughout the year. This fever occurs mainly in the dry season and is said girls are more often affected, the current increase in cases occurred at ages under 5 years old.
# How Typhoid Fever Disease Transmission
Typhoid fever can strike when the germs enter through food or drink, resulting in infection of the digestive tract of the small intestine. And through the bloodstream, the bacteria reach the organs especially the liver and spleen. He then proliferate in the liver and spleen that causes pain when touched.
# Signs and Symptoms of Typhoid Fever
This disease can strike when the bacteria enter through food or drink, resulting in infection of the digestive tract of the small intestine. Then follow the bloodstream, the bacteria reach the liver and spleen that proliferate there causing pain when touched.
Clinical symptoms of typhoid fever in children usually give a mild clinical picture can be even without symptoms (asymptomatic). Broadly speaking, the signs and symptoms that include;
1. Fever more than a week. During the day usually looks fresh but before the night a high fever.
2. Tongue dirty. The middle part is white and red edges. Usually the child will feel bitter tongue and tend to want to eat the sour-sour or spicy.
3. Weight nausea to vomiting. Salmonella typhi bacteria proliferate in liver and spleen, the result is swelling and eventually suppress the stomach, causing nausea. Due to excessive nausea, eventually enter the food can not be perfect and usually come out again through the mouth.
4. Diarrhea or Diarrhoea. The nature of the bacteria that attacks the gastrointestinal absorption of fluid that causes the disorder eventually occurs diarrhea, but in some cases actually occur constipation (difficult bowel movements).
5. Weakness, dizziness, and abdominal pain. A high fever cause weakness, dizziness. Swelling of the liver and spleen causing pain in the abdomen.
6. Unconscious, not conscious. Patients generally feel more comfortable with a lie without much movement, but with a severe condition that often occurs disturbance of consciousness.
# Diagnosis of Typhoid Fever Disease
For the accuracy in the enforcement of diagnosis of disease, the doctor will perform several laboratory tests including peripheral blood examination, Widal examination and culture of bile.
1. Examination of peripheral blood is a simple examination that is easily done in a simple lab to make a quick diagnosis. There will be a picture of a reduced white blood count (leukopenia), increased the number limfosis and eosinophilia.
2. Widal examinations are blood tests to find an anti against typhoid germs. If positive Widal O titers 1 / 200 or more and or show a progressive increase.
3. Typhoid fever diagnosis must be positive if done with the finding of bile culture bacteria Salmonella typhosa in the blood of the first week and then often found in the urine and faeces.
Positive blood samples are made for definite diagnosis. Urine and faeces samples two times in a row is used to determine that the patient has completely recovered and not the germ carrier (carrier).
Meanwhile, to ascertain whether the illnesses suffered by patients is another disease it is necessary to diagnosis. If there is a fever of more than five days, the doctor will think about the possibility of typhoid fever in addition to the other infectious diseases such as paratyphoid A, B and C, dengue fever , influenza, malaria, tuberculosis (TB) and lung infection (pneumonia).
# Care and Treatment of Typhoid Fever
Care and treatment of patients with typhoid fever illnesses or types aimed at stopping the invasion of bacteria, shortening the course of the disease, prevent complications, and did not prevent recurrence. Treatment of typhoid disease conducted by isolating patients and conduct disinfection of clothing, faeces and urine to prevent transmission. The patient must lie down in bed for three days until the heat down, and then be sitting, standing and walking.
Apart from drugs given to relieve symptoms such as fever and dizziness (Paracetamol), For a child with typhoid fever is the primary choice of antibiotic is chloramphenicol for 10 days and is expected to occur eradication / eradication of the bacteria and the treatment time is shortened. But there are some doctors who chose other antibiotics such as ampicillin, trimethoprim-sulfamethoxazole, cotrimoxazole, cephalosporins, and ciprofloxacin according to the patient's condition. Excessive fever causing the patient to be treated and given fluids infusion.
# Complications of Typhoid Fever Disease
Complications are common in children with typhoid fever is intestinal bleeding due to perforation, infection of the gallbladder (cholecystitis), and hepatitis. Brain disorder (encephalopathy) is sometimes found also in children.
Typhoid fever disease patients during treatment should follow the instructions diet recommended by doctors for consumption, among others:
1. Foods that are quite fluid, calories, vitamins & proteins.
2. Does not contain much fiber.
3. Not stimulating and does not cause a lot of gas.
4. Food is provided during breaks.
To return to the food "normal", do it gradually along with the mobilization. For example the first and second day of soft food, day-to-three regular meals, and so on.
# Prevention of Typhoid Fever Disease
Typhoid fever prevention of diseases can be done by way of improved hygiene and environmental sanitation and health education. Immunization using oral vaccines and vaccine injections (Polysaccharida capular Vi antigen) has been widely used. Currently the prevention of Salmonella bacteria can be done with named chotipa vaccination (cholera, typhoid, paratyphoid) or TIPA (typhoid-paratyphoid). For children aged 2 years who are still vulnerable, can also be vaccinated.
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