I live in Dhaka, Bangladesh. In spite of the best efforts by the local government and various international organizations to improve the overall public health and welfare situation, diseases such as cholera, malaria, dengue fever, typhoid, tuberculosis, filariasis and many more are still common in this country. As you will notice, most of these diseases are a result of parasitic infections — this is typical of many tropical countries, especially those whose health and sanitation infrastructure is not well developed. While not reaching epidemic proportions, occasional localized outbreaks of such diseases are not unheard of in Bangladesh; fortunately the local government and various non-governmental organizations (NGOs), which typically provide aid and development services, successfully handle these small outbreaks.
Living in Dhaka, there are many precautions one must take not to fall prey to disease: sleeping under mosquito nets, drinking only bottled or properly filtered water, never eating food prepared and sold by street vendors, never using public or shared restrooms — the list goes on and on. Despite my best efforts in maintaining all these rules, most of which have become second nature, I ended up with a typhoid infection. The most common vector of this disease is via the ingestion of food or water contaminated by a species of typhoid causing Salmonella bacteria called Salmonella typhi. These bacteria are spread when sewage water is ingested or when a typhoid carrier handles the food you are about to eat. I have tried my best to retrace my steps and am at a loss as to where I could have been infected. I never eat anything other than meals prepared at home and only drink bottled water. In the in end, all that mattered was that I had become infected and I was going to be very sick.
Typhoid fever symptoms vary among sufferers. Typical symptoms include high fever, loss of appetite, a bleeding nose, stomach aches, headaches, lowered heart rate, extreme weakness, and a rash of red spots on the body. Other than the rash of spots and the bloody nose, I can safely say I went through all the symptoms with varying degrees of severity. Initially I thought I had the flu or common cold — the symptoms were indistinguishable: general weakness, fever and a loss of appetite. Usually when I have the cold I’ll stay in bed, eat a lot of soup and pass the time sleeping and doing crosswords online. I knew there was something wrong when this time I didn’t have the strength and mental energy to sit up in front of my laptop (which is conveniently located near my bed) and work on any crossword. In fact, I had trouble focusing on simply reading the clues and found it increasingly difficult to sit up for any length of time. This went on for nearly a week with the symptoms gradually getting worse: the fever increased, my weakness got worse, and I experienced a total loss of appetite.
Progression of Symptoms and Medication
I found that I was unable to eat anything; I literally had no appetite. I would sit in front of my plate at the dinner table and move things around with my fork. Eventually I would try to eat a piece of beef but would only chew it endlessly with no desire to swallow; any attempt to force myself to swallow food would only raise my gag reflex causing me to vomit. My tongue could not taste the beef or most of the other items on the plate. I knew instinctively how these things should taste from experience, but for some reason I could not taste anything. It was as if my taste buds had stopped working. In the end I essentially gave up on solid food and switched to soups and broths, and even those I could only eat a little at a time. I found it easier to have six or seven small meals a day as it allowed me to eat smaller portions while hopefully getting the required nourishment by the end of the day. I found myself eating a lot of fruits. Whereas I could not taste beef or other cooked food, I had no trouble tasting certain fruits, especially oranges, pears, grapes, and pomegranates. I would also drink loads of water and orange juice, much more than I normally do. This had the unfortunate side effect of sending me to the restroom every few hours to relieve myself, which was a difficult and unpleasant task in my weakened state, but I felt it was necessary to always stay hydrated, a sentiment confirmed by my doctor later on.
Even with all my attempts at trying to maintain a regular eating schedule, it was obvious I was losing weight and getting weaker. Though I would urinate frequently, I would pass solids once every three or four days. At this point the only medication I was using was paracetamol (acetaminophen). I would take two tablets every time the fever got really high (I regularly measured my own temperature) and it immediately reduced the fever and made me feel more or less normal. I didn’t like taking paracetamol because even though the fever would subside and I would feel normal, I would become very restless and start sweating heavily. While on paracetamol I could not focus on anything in particular would pace about the house. Sometimes watching TV while eating something that kept my hands busy (grapes, oranges or pomegranates for example) would alleviate the feelings of restlessness. The effects of the paracetamol would last anywhere from two to four hours, after which I would suddenly start to feel very cold and weak and would go back to being sick.
By the end of the first week a GP made a house call and examined me. He chided me for waiting an entire week before calling him, gave me a full physical exam and checked my blood pressure; it turned out I had lower than average blood pressure in addition to all my other symptoms. He confirmed most of my symptoms and immediately suspected typhoid, but did not rule out the likelihood of hepatitis, and ordered a series of blood culture tests to be taken at a private clinic. I was very concerned at the possibility of having hepatitis, and as absurd as it sounds, was hoping and praying for the blood test results to show typhoid.
I hope these personal description of the symptoms I experienced help you in understanding something of the disease. Here is some additional information on how typhoid fever is spread.