What Exactly Is Typhoid Fever?

Typhoid fever. Simply put, it’s a bacterial infection that
comes largely from contaminated food, water, or sewage. But it’s not just a fever, typhoid can tear
holes in your intestines and infect many other organs in your body. Oh, and it’s uniquely evolving to become
more and more drug resistant. Typhoid fever is caused by a salmonella bacteria,
but not the salmonella you’re probably thinking of. So the salmonella typhi bacteria is different
from the salmonella that you might see in the U.S., which is the foodborne salmonellosis. I’m Anita Zaidi and I’m the director for the
Bill and Melinda Gates Foundation’s Enteric and Diarrheal Disease team and the vaccine
development and surveillance team. One of my reasons that I was very attracted
to working at the foundation was there was an interest in working on diseases of the
poor. And Typhoid was one of the problems that I thought
I could solve. So while salmonellosis is transmitted via
infected animals and it consumed usually on raw meat or eggs. Typhoid is different in that it only infects
humans. But it is pretty good at surviving outside its human host until it gets picked up again, like by someone drinking contaminated
water. So what happens when, let’s say that you drink
100,000 organisms of salmonella? First it goes to your stomach, right? And over there, if you’re a healthy person
and you have lots of stomach gastric acid, which healthy people should have. Most people will actually, the stomach acid will kill those salmonella and you won’t get sick. But children, and some adults, who don’t produce
a lot of stomach acid have a higher susceptibility of getting a typhoid infection. If the typhoid bacteria aren’t killed by
stomach acid like they should be, they travel to the terminal part of the small intestine
and enter the cells lining the intestines. This provokes a massive immune response. What happens is the inflammatory response
is unconstrained, or too much, and it punctures a hole in the intestine where the inflammation, inflammatory response is happening. So basically ulcerates, if that’s a good way
of thinking about it. Like a pustule almost think about it, right? When you get a pustule and that pustule bursts,
that’s what happens inside the intestine because you have all of those white cells together
eating away the tissue. Now your bowel contents are coming out in
your abdomen and then that makes people very, very sick. From here they get into lymphoid tissue underlying
the enterocytes, called Peyer’s patches and then into the bloodstream and spread widely
to many organs of the body, especially the liver, spleen, and bone marrow. They also re-enter the intestine through the
bile draining from the liver into the gallbladder and then upper intestine so they can be excreted
in feces and spread to other people. In some cases, the typhoid bacteria cause ulceration
of the Peyer’s patches all the way through to the outer lining of the terminal ileum
resulting in a perforation of the small intestine, a very dangerous condition that can kill unless
repair can happen through open abdominal surgery. The bacteria spreads ferociously to other
organs like the brain, heart, and pancreas. Inflammation then occurring in these areas
can cause pancreatitis, meningitis, and a whole host of other problems. These are the most serious complications of
typhoid and they happen after already being sick for 2-3 weeks.. Leading up to this, the patient feels extreme
fatigue set in and a fever that can gradually increase to dangerously high levels. Other symptoms include headache, muscle aches,
loss of appetite, diarrhea, and a rash. Diarrhea flushes the salmonella typhi out
of its human host and back into the sewage system. From here, the bacteria can spread rapidly
in areas with poor sanitation. This is what’s known as the fecal-oral route
of transmission. So you start having fever and slowly the fever
gets worse and worse and worse over time because the organism makes you sick slowly. Instead of very fast. So if a bug gets in you and it kills you very
fast, it can’t be spread. But typhi is very clever. So what it does, it doesn’t kill you fast. It kills you slowly. And by that time you already spread the infection
to other people. It’s a survival tactic for typhi. Throughout the process, the bacteria evades
the immune system by living inside of human cells. And since it can live inside macrophage cells
in the bloodstream and tissues, it can evade the immune system for some time. The good news is typhoid can be treated with
antibiotics. The bad news is that some drugs that were
highly effective in the past can no longer combat the more evolved strains of salmonella
typhi. These are what are known as “Extensively
Drug-Resistant” or XDR. Now, there’s very few drugs that are left
to treat it, if you have the XDR type of typhoid. … Which is why it was so important to have
vaccines for typhoid. And so until recently we did have some vaccines,
but those vaccines worked only in older people. So older than six years old. Some of the really exciting work
on typhoid has been around actually developing what we call a conjugate vaccine. The protein-carbohydrate conjugation makes
the vaccine work for very young children, as their immune systems aren’t fully developed
to handle carbohydrate antigens by themselves. In a small number of cases after someone has
recovered from typhoid, the bacteria will live on, hiding out in their gallbladder. These people are known as carriers and can
infect the people around them. And that’s the story of the famous Typhoid Mary
who wasn’t sick, but actually had a really high infection burden of salmonella typhi
and she was a cook in New York. And so whichever family she would go and work
for, there would be an outbreak of typhoid, and eventually they had to put her in confinement
so that she couldn’t spread the infection anymore.

80 thoughts on “What Exactly Is Typhoid Fever?

  1. Thought I had it once. My palms were sweaty, knees were weak, arms were heavy, started vomiting…


  2. Hahahaha.
    My cronical gastritis is useful for something.
    I am super immune!
    Unless I take an acid inhibitor, in which case gastritis will be my trojan horse. FACK!

  3. How bad would it feel to find out your a "typhoid mary" for anything, and that not only must you live out your days in confinement with no human contact, but that you also have been the "seed" for many others slow excruciating deaths, exspecially children. Would i continue to live, i suppose, be a researcher or something as such, probably researching your desease?

  4. Lovely way to wake up! Bacteria that shred my digestive track like buckshot, minus the holes for shit to leak out, yay me!

  5. Bill and Melinda Gates are racist because they didn't hire a black lesbian Jamaican+Jewish woman to be the director of whatever it is. Instead they hired a brown skinned Pakistani woman. Well, I guess they get some "woke" virtue points for hiring a brown skinned Muslim woman instead of a brown skinned Muslim man, but let's face it, if they really want to promote the woke progressive gender-based Marxist identity politics agenda then they have to go all the way and score as many victim points as possible. This means combining black with female plus some sort of LGBTQ preference and Jews are preferred. When they do that then I won't see the Gate's as racists, only hypocrite virtue signallers. Oh, and they have to vote for Pocahontas and Bernie.

  6. Just a question out of curiosity: why on these "SICK" series all of the invited experts always are foreign people(Indians, French, Arabs, Italians, etc), with English language not being their primary? Is it just a coincidence?

  7. Thank you, now i really know, why one of my relative, who was treated for typhoid, now have surgery to treat a hole in his intestine.

  8. So do we screen immigrants for this? One more reason to build the wall, and have extreme vetting for anyone stepping into the United States. And voting out Dems in California that are destroying the state with drug addicts, Illegals and attracting the worst types of people that prey on society and contribute nothing. Typhoid, Typhus, Measles and other 3rd world illness are rampant in Sanctuary Cities.

  9. I'm procrastinating in YouTube but still learning about diseases that we know very little about in my so-called developed country (I'm almost MD). Thanks SICK.

  10. I had typiod recently …. Actually 2 type of typiod … Dr. Treated me with antibiotics for 2 days …. And it was all gone …..
    But my liver was suffering 😭 because of strong medicines the Dr. Gave me …. And my immunity system become very weak
    Not only that my body was in great deficiency of vitamin and minerals
    I suffer for 4-5 months …. And still recovering 😖

  11. This video was very thoughtfully produced.

    It's simple enough to educate the layperson yet I was still able to learn something as a med student.

  12. I had typhoid when I was 10 or 11, luckily it was spotted quick and didn't get any ruptures in my intestines, had to stay in the hospital for week.

  13. Rather than vaccination, prevention is better. India needs to be more sanitary and typhoid won’t be an issue.

  14. Most indians for example have holes in their brains and that makes them smell like cheese.
    Don't send bobs and vagana and subscribe to pewdiepie !

  15. There are six worst places on human body where pain and other sickness strikes:

    1. Pain in the Ass

    2. Toothache

    3. Pain in sex organ

    4. Uncontrolled and unstoppable vomiting no matter what's the cause

    5. Trouble with lungs where you 'consider' you don't get much or high quality air i. e. choking

    6. Heart pain

    There is no worse than this.

  16. If this scares the shit out of you, don’t fear. If the worst happens and the bacteria becomes totally resistant to Antibiotics, you still have Bacteriophages which can destroy the bacteria. Bacteriophage therapy is used today to cure all kinds of super bacteria today.

  17. Interesting!! Thank you for the information! Is possible to design two different nanobots? One for combating typhoid and the other one to investigate the gene(s) of a typhoid?

  18. All you westerners wondering what this whole thing feels like, you're welcome to come to India, the world's capital for water borne diseases, to experience it first hand.
    You won't have to pay much either. Simply visit any village in any part of India and take one sip of drinking water and you're good to go. You're bound to experience the full bout of Typhoid given there aren't any toilets in villages and healthcare facilities have neither healthcare nor are they facilities. Add it to your bucket list of things to do before you die – you might want to place this one at the bottom of the though.

  19. I've had typhoid more than twelve times, I lost count after the twelvth time I was diagnosed.

    I at one point reached week two symptoms, to say the least it was bad.
    Delerium had set in at that point.

  20. Eventually we'll need sewer clean up inside our bodies.
    I recommend to first research colon cleansing with such technology, to learn and develop more acces into trickier parts of the body.
    And I'm not joking: we could learn a lot about such environments from "Aliens".
    – being there!
    – being autonomous!
    – learn from recent experiences in vitro
    – finally overcome the pre made plans and learn how to adept from the field!
    I volunteer personally, If you provide me evidence that giving my life to a university or something actually could work.
    No joke, text me here!

  21. I work in municipal water treatment, i.e. city water. Chlorine is one plentiful chemical known to be able to kill this organism in water. Occasionally, city water systems are criticized for using chemical disinfectants. Maybe the critics would prefer typhoid.

  22. Thanks San Francisco 🥳
    Before you get bent out of shape look up homeless in California

  23. Fear mongering. Tell us more how we could die. Dont forget to add that it is becoming harder to fight. Keep in mind that many of us are filled with anxiety disorders so this is clearly helping those people. Just so you know many people with anxiety disorders look to science for uplifting results to ease their fears. I think it's time to unsubscribe to this channel. Enough is enough.

  24. Why the heck the doctor is smiling while telling about typhoid, like she's telling a inspiring life story of a typhoid bacteria. Which she just did.

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