Can Covid 19 and typhoid fever occur together?

Has anyone around you got Covid 19 disease and detected to be affected by typhoid fever? 

Yes it is a common picture creating confusion for many people. They are investigated for the cause of fever, sometimes the cause of fever is detected to be typhoid. Eventually in this pandemic they are found to be positive for Covid 19 too.

Let us discuss whether typhoid and covid occur together or not.

Symptoms of Covid 19

Covid-19 has been predominantly affecting the entire population of the word since 1 year. By now you must be already familiar with the symptoms of the covid-19. For those who don’t know let us discuss the covid-19 symptoms here. 

So symptoms of the covid-19 are as follows:

  • Fever: This is the common symptom of the covid-19. Fever may be initially mild grade and as the time progresses it may become moderate to high grade. In some patients it may be associated with chills and rigor. It may go up to 104 Fahrenheit to 106 Fahrenheit. It may be partially responding that is not decreasing with common medications like paracetamol and Ibuprofen.
  • Cold: This is also a common symptom of the covid-19. In most of the patients covid-19 disease starts with the symptoms of cough cold fever. It may be associated with blocked nose, sneezing, running nose and other common cold-like symptoms.
  • Cough: Patients may have cough from the first day itself or may develop it on some days of fever and cold. The cough may be dry and in some patients it may be associated with expectoration.
  • Sore throat: Some patient complaints of sore throat. It may be associated with feeling of itchiness and dryness of the throat.
  • Weakness and fatigue: initially patients may not have weakness and fatigue. As the time progresses weakness and fatigue may increase to the extent the patient is not able to stand or get out of bed.
  • Breathlessness: with the progression of disease as the severity of disease increases and more part of the lung is involved, patients may have breathlessness. The severity of the breathlessness may increase so that the patient may need artificial ventilator support or oxygenation.
  • Loss of smell and taste sensation: few covid patients have a loss of smell and taste sensations. Mild symptomatic patient for severely symptomatic patients may have this loss of smell and taste sensation.
  • Skin rash: Some patients of covid-19 develop skin rash. The skin rash can be present on any part of the skin in the form of papules, macules or urticaria like lesions. Typically some patients get a rash on the tip of the fingers.
  • Some less common symptoms are abdominal pain and diarrhoea.

Symptoms of Typhoid

In the above paragraph we have discussed the symptoms of the covid-19 in short.

Now we will briefly discuss the symptoms of typhoid fever.

So symptoms of the typhoid fever are as follows:

  • Fever: Fever is initially mild grade and then as the disease progresses it may become moderate to high grade. It may be associated with chills and rigors in some patients. Initially it may be responding to simple medicines like paracetamol. As disease progresses the fever may not decrease with the simple medicines like paracetamol and Ibuprofen.
  • Fatigue and weakness: patients of typhoid fever may have fatigue and weakness.
  • Diarrhoea and constipation: diarrhoea is a common symptom in typhoid fever. Patients may suffer from constipation because of typhoid. Some patients of typhoid fever have constipation followed by diarrhoea.
  • Loss of appetite: many patients of typhoid fever suffer from loss of appetite. They don’t feel like eating.
  • Abdominal pain: As the intestine is affected by the typhoid fever patient may suffer from abdominal pain. If left untreated patient may suffer from intestinal rupture and severe abdominal pain.
  • Initial stages of typhoid fever may present like an upper respiratory tract infection.
  • Skin rash: Typhoid skin rash is difficult to identify as it is faint in colour. Typhoid skin rash generally appears in the third week of the illness. It is difficult to identify patients with dark skin colour.

How does covid 19 spread?

Since last one year there is a lot of discussion about how covid-19 spreads in the media. Initially the mode spread of this deadly disease was not known.

But now after one year week definitely know how the covid-19 spreads from one person to another. Here we will summarise the mode of spread of covid-19 disease.

  • When the infected person talks or sneezes or coughs, the secretion from the mouth and the respiratory tract of the patient and suspended in the air. When the people surrounding the infected person breathe the air containing the virus they get infected.
  • Covid-19 infection also spreads from the surfaces. The virus may lie on the surfaces like table, door knobs, buttons of the lift. When you touch those objects and then touch them with your hands, nose or eyes, you may get infected.
  • Because of this nature of the spread of the covid-19 virus, it can spread very rapidly in the community. This explosive spread has all the tsunami of the epidemic leading to pandemic.

How does Typhoid spread?

Now let us discuss how typhoid fever spreads from one person to another.

  • Infected person shreds the typhoid bacteria in the urine and stool. If this urine and stool come in contact with the water it contaminates the water. If the susceptible person drink this water he may get infected with the Typhoid bacteria.
  • If the hygiene is poor in an infected person and the person does not wash the hand after the toilet , such a person if touches the food may get contaminated. If the susceptible person consumes such food the infection may spread.
  • Also open defecation practices can spread the infection very effectively. Flies sit on human feces and if they sit on the food the bacteria may spread from feces to the food.
  • If someone consumes the seafood contaminated with salmonella he may get infected with typhoid.

So it is clear that the typhoid infection spreads by the water or food.

Typhoid tests in Covid 19?

As we have seen the symptoms of covid-19 and also the symptoms of typhoid fever, you may know there is some similarity in the symptoms.

Both these diseases may have fever that is similar in nature and also have fatigue and weakness. So for investigation in the patient with fever all the tests are needed for the disease of the diagnosis.

Most of the fever patient and suggested to do the test for common illnesses like, malaria dengue and typhoid.

Widal test is commonly suggested if typhoid fever is suspected. Though the widal test is done, it is not the confirmatory test. For the confirmation of the typhoid fever blood culture is the ideal investigation.

Typhoid infection can be detected in urine culture and also stool culture. Many of these tests are not available in other parts of the world. Widal tests are not confirmatory. It is widely used as it is simple and available in most parts of the world.

Issues with test

The problem of the widal test is it is not the confirmatory test for typhoid fever. There are limitations to the test and they are as follows:

  • As we discussed earlier, a widal test is not the confirmatory test for the diagnosis of typhoid fever.
  • Widal test detects the antibody titer against typhoid fever.
  • This test may come false positive in many other illnesses including covid-19 infection.
  • So sometimes patients are diagnosed as typhoid fever and later on they are found to be infected with covid 19.

Can both occur together?

We should keep in mind that both of the diseases are associated with similar symptoms. They are two different diseases and we are susceptible to both of them.

Yes there are instances where both the infection can occur together. The mode of spread of the diseases is different but in some unfortunate they both occur together.

There is no direct correlation between the covid-19 and typhoid fever. Covid-19 place with the immunity of the patients. Patients who have diabetes and hypertension may have weak immunity and when covid-19 affects him they may become more susceptible to typhoid.

Why confusion?

You know about this question we have gather the knowledge about the covid-19 and typhoid fever. As we know in most parts of the world confirmatory test are not available and they are difficult to carry out.

Additionally the symptoms of both the diseases are similar to some extent.

So limitations of the tests and similarity of the symptoms in clinical picture my cause to confusion whether you have typhoid or covid-19 infection or both together

What is the solution to this problem?

The only solution to this problem is making test available in all parts of the world to diagnose covid-19 and typhoid fever. 

Additionally wherever there is confusion the second opinion of infectious disease specialists should be considered. All the patients with high grade fever should have their blood culture done before starting the course of antibiotics. 

The sample of blood culture should be collected with the proper procedure.

The sample of the blood culture should be collected without contamination.

The sample of the blood culture should be preferably collected when a fever patient has high grade fever. When the chances of bacteremia are high.

About treatment in such cases

In most of the covid-19 patient antibiotics and started if they have pneumonia and high grade fever. 

Most of these antibiotics are broad spectrum and they are also effective against typhoid fever.

Many times typhoid fever cannot be detected even with confirmatory test because of limitations of the tests.

In such cases the broad spectrum antibiotics should be selected that are effective against pneumonia and also against typhoid fever.

The opinion of infectious disease specialists should be considered.

In most of the parts of the world typhoid infection is resistant to many antibiotics commonly used. This fact should be considered while treating the patients. The culture sensitivity report if positive main throw some light about the resistance in the bacteria.

So we think most of the doubts about the covid-19 infection and typhoid fever occurring together has been solved in this blog post. If you have any further doubts you can comment in the comment section.

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