Claim: Too much stress causes typhoid
Verdict: No. Stress does not cause typhoid as some Nigerians claim
In Nigeria, it has become a common assumption that whenever a person is sick and diagnosed with typhoid, it is often attributed to stress and such a person would be advised to try to rest well.
A Twitter user known as Code and vibes (@pharuc1) wrote that the stress from commuting from mainland Lagos to Island has made him sick with typhoid.
Another tweeter known as Oyindamola ( @portable_wendy1), who lamented of not being paid by her boss in a thread of tweets, narrated that she got down with typhoid as a result of the stress she went through having commuted from Sango-Ota, Ogun State to Yaba, Lagos State.
According to the popular medical news website, Medicalnewstoday, typhoid is a bacterial infection that can lead to a high fever, diarrhea, and vomiting. It can be fatal. It is caused by the bacteria salmonella typhi.
The infection is often passed on through contaminated food and drinking water, and it is more prevalent in places where handwashing is less frequent. It can also be passed on by carriers who do not know they carry the bacteria.
In the same manner, webmd.com describes typhoid as an acute illness associated with fever caused by the salmonella enterica serotype typhi bacteria. It can also be caused by salmonella paratyphi, a related bacterium that usually causes a less severe illness. The bacteria are deposited in water or food by a human carrier and are then spread to other people in the area.
According to Asian Pacific Journal of Tropical Medicine, typhoid incidence ranges from 3.9% to 18.6%.
How do people get typhoid fever?
A gastroenterologist, Dr. Seyi Akande, explained in an interview with this fact-checker that typhoid is contracted when infected faeces contaminate the food, hand or drink of another person. According to him, the microorganism responsible for that typhoid known as salmonella gets into the body through the mouth and gets out through faeces.
He explained, “Salmonella typhi is a microorganism that is found in faeces. So, whenever you have an unhygienic condition there are chances of spread of typhoid. For instance, if the water is close to where the toilet is or people that are handling food go to the toilet and don’t wash their hands. Or people that have long nails allow faeces and dirt to hide under the nails and use those hands to cook food then one can get infected by eating the food. That is why it is important to do typhoid tests for food handlers before you certify fit to offer food service.
“Anything that will make people ingest food or water that is contaminated through the mouth can lead to typhoid, even though it is not every time that people get down with the disease because the body has a general way of fighting these diseases. For instance, the stomach is acidic so this acidity kills a lot of these typhoid bacteria. But if they are many, some can escape this acidity and get to the small intestine then to the body. Unhygienic conditions lead to typhoid,” Dr. Akande added.
How is typhoid fever diagnosed?
The gastroenterologist further explained that typhoid is diagnosed first and foremost by the symptoms the patient presents. If the patients have continuous fever, not the intermittent one.
The intermittent fever can come in the morning and you don’t see it again in the evening, that is common to malaria but the typhoid fever is continuous. Also, a person with typhoid will have headache, commonly they will have abdominal pain. Sometimes, they could have constipation or pass stool less frequently. They may also have diarrhea. Usually because we are dark skin, we might not easily see the rashes that typhoid causes but in those that are light skinned, you will suspect that a patient is having typhoid.
Dr. Akande added, “Then there are tests that you can then do. For instance, you can take blood samples of the patient and do salmonella typhi not that widal test. You can take the stool or urine of the patient depending on how long the patient has been having symptoms whether the first, second week, or whenever.
What is the relationship between typhoid and stress?
Akande said that the foregoing question is one of the problems in Nigeria with the diagnosis of typhoid.
He stated, “We call some doctors malaria-typhoid doctors because once there is fever; they will think it is either malaria or typhoid. It is good to think of malaria because it is common in our community but it is not every fever that is typhoid. The notion that whenever you treat malaria and it doesn’t go then you have typhoid is very wrong.”
In the same vein, Dr Tunji Akintade, a general physician and the immediate past president of the Lagos Chapter of the Association of General and Private Medical Practitioners of Nigeria, also corroborated his colleague that typhoid is an infection caused by bacteria called salmonella.
He further explained that the signs and symptoms of this disease are fever(hotness of the body), severe headache, abdominal pain among others.
“Complications that can arise from it include intestinal perforation, psychosis and severe anaemia. All these(disease + complications) are stressor to the human body. Let me categorically state for educational purposes. Diagnosis of typhoid is both clinical and laboratory. The laboratory aspect of it is blood culture, not widal test,” the medical practitioner explained.
Akintade explained that the corresponding response will be based on clinical evidence seen. These responses may include further investigation or intervention which can be surgery, blood transfusion, or even all of the above.
He said, “prevention of this illness is basically water hygiene not drugs. Vaccines has also been useful.”
What is stress?
The doctor explained, “Stress itself is defined as a state of mental or emotional strain or tension caused by adverse (physical, biological or chemical) circumstances.
“Stress on its own can easily be handled by identifying the stressor which like I said above can be biological, physical or chemical. Once you identify it, you remove it before it tampers with your emotional or mental state.
“Resting plays a major role in all stressor but it has to be in addition to removing the stressor. When you rest, you conserve energy, build up your immunity and your protein store and you get well hydrated.”
Does stress really cause typhoid?
Akande empathetically said that stress does not in any way cause typhoid.
He said, “Typhoid is not caused by stress. Typhoid is caused by a biological organism called salmonella. It is the cause of typhoid that is a biological stressor.
“In the above subject matter, the cause of typhoid is biological (bacteria) triggering chemical and emotional circumstances.”
Typhoid is not caused by stress, rather it is caused by a microorganism known as salmonella typhi.
Source: The PUNCH