Typhoid comes from swallowing water or food that has been in contact with human waste. It builds slowly over a week rather than arriving overnight, and in Cameroon it is both genuinely common and very commonly diagnosed when it is not there.
What it looks like
- Fever that climbs a little higher each day over about a week, rather than spiking and falling.
- Headache, a dull stomach ache, and deep tiredness.
- Poor appetite, and often constipation rather than diarrhoea in adults.
- Sometimes a slow pulse despite a high fever.
Go to hospital now if
- Severe stomach pain that becomes suddenly worse, with a hard, board-like belly. This can be a perforated gut, which is a surgical emergency.
- Blood in the stool, or black tarry stool.
- Confusion or drowsiness.
- Vomiting everything, or unable to drink.
About the Widal test
The Widal test is widely used here and is widely wrong. It cross-reacts with malaria and with past infection, so in a place where most adults have had both, a "positive Widal" on its own means very little. People are treated with repeated courses of antibiotics on the strength of it, which is how resistance grows. A stool or blood culture, or a more specific test, is what settles it. If a clinician offers only a Widal, it is reasonable to ask what else is available.
Prevention is plumbing, not tablets
- Drink water that has been boiled, filtered or properly treated.
- Wash hands with soap after the toilet and before food. This is the single biggest one.
- Peel fruit yourself, and be careful with food left standing and with ice from unknown water.
- Typhoid vaccination exists and is worth asking about, particularly for children in high-burden areas.
