I woke on our last night on Zanzibar to the sound of retching and found my travel buddy sweaty and miserable on the bathroom floor. With the certainty you get from hours of gaining your medical degree off of Google, she announced she'd got too much sun and not enough water the previous afternoon. My superior degree from WebMD had me putting forth a diagnosis of food poisoning; and in the morning, our more experienced African guide declared it to be malaria.
Off we went to the medical clinic through the busy town, dragging a sweaty mess behind us. At one point a man on a bicycle came to a dead stop in front of us, eyed her up and down and fearfully whispered "malaria!" at her before pedaling quickly off. Minutes later we were in the clinic as a doctor took a quick $5 rapid blood test for malaria; that's all it costs to diagnose malaria even in rural Africa, and yet thousands die annually for it. While we pondered that depressing fact, the doctor made his way back to us with the results: negative.
My WebMD credentials were looking a bit better.Trying to Let it Pass in Tanzania
With no definitive diagnosis we set off again for a long, brutally choppy ferry crossing and then hours stuck in traffic in the capital of Tanzania. When we stopped at the hotel for the night, she wouldn't eat and went straight to bed, waking up only to be sick through the night. To this day, I have never seen someone as sick as she was in those first few days.
The next day on the truck was a long drive to Arusha where we would be switching trucks and guides and gearing up for long drives through the Serengeti. On long drive days it's not uncommon for us to spend half the time napping in our sleeping bags in the back of the truck; most days require a 5am start and I've never been a morning person.
When the truck stopped for its typical break, where we can make use of the bushes or stretch our legs, I blearily opened my eyes and decided I was too tired to get up. That's when my guide decided something was wrong with me. I might be the laziest human known to man, but I never pass up a chance to make use of the bushes. Endless hours on badly paved African roads with a full bladder are my idea of personal hell.
By the time we pulled into Arusha, I felt off. That's it. Nothing really hurt, I was a bit tired but when am I not tired? I was taking care of a sick girl who was genuinely very, very ill and here all I felt was some indescribable, probably hypochondriac-induced off-kilter way. Nonetheless, my guide labeled me as a possible malaria victim and insisted I get the test before we headed off into the bush for four days. There's no hospitals in the Serengeti. I agreed and we began our wait for the taxi.
It was around this point, arms crossed over my chest, I idly touched my left elbow and felt bumps. Surprised, I pulled my elbow around to take a look. We all stared at the angry red bumpy mess that now encircled my elbow.
"What the hell is this?!" I demanded of everyone and anything standing nearby. The guides thought it might be an insect bite except it didn't itch. I was trying to get the hypochondriac of our group to touch it when the taxi finally pulled up. I climbed in, bemused and inspecting my arm. By the time we had reached the hospital fifteen minutes later, the rash was climbing up my left arm and had spread to my legs and right arm. Lovely. It was growing.
Definitely Typhoid
I stood panicky in the doctor's office while he barely took a glance at my rapidly deteriorating body before he boldly declared it was typhoid. I had some vague notion of typhoid since my travel clinic in the US had told me they don't vaccinate for it; how ironic would it have been if I had the one tropical disease that my twenty six injections didn't cover?
He listed off the various symptoms of typhoid: vomiting, diarrhea, fever, abdominal pains, headaches, and poor appetite. I didn't have any of these symptoms. He hadn't even mentioned never-ending rash as one. I was clearly fine. I got the blood test done and the results were back in a few minutes, handed directly to me in a stack that the blood tech asked me to take to the doctor. I flipped through them as I walked back to his office with my guide, trying to understand various lines of medical jargon, until I found what I was looking for:
Malaria: negative
TyphoidH: negative
Ha! I proclaimed myself typhoid free and obviously bound for medical school to my guide until she leaned over and asked, "what's the positive result for?" And there it was:
Typhoid O: positive
Turns out there's two types of typhoid out there, and I got the lovely letter O. I went back to the doctor and defeatedly announced my own diagnosis for him. As he wrote out a prescription for antibiotics and assured me I wouldn't die and my limbs wouldn't rot off anytime soon, he looked up and asked me if I knew where typhoid came from.
Please don't let it be feces, please don't let it be feces.
"Contaminated water. Contaminated with human feces".Be Careful With Typhoid
While I recovered without any problems and never experienced any other symptoms than the weird looking rash and exhaustion, typhoid can be a serious problem. Based on the fact that all the symptoms listed by the doctor were what my sick friend was experiencing, despite the fact that she had had the typhoid vaccination three months prior, we had her brought in for the test as a precaution. She tested positive for both strains.
It is important to note that left untreated, typhoid can lead to permanent problems and serious consequences like a perforated bowel or even death. In our case, we were both treated with a broad spectrum antibiotic known as Flucloxacillin. While I tested fine at the ten day blood check, she was still infected. More antibiotics were prescribed, and weeks later she was still very ill. Finally, we found a doctor who informed us that typhoid has up to a 96% resistance rate to the original drug prescribed, and a better drug was prescribed; further research I've done into clinical studies has backed this claim. Also, it helps to know that the vaccine isn't 100% effective in fighting this infection, it's not even close to that. She came along absolutely positive she didn't have the infection but thought better safe than sorry; in her case, that was the best advice and could have possibly saved her life.
Perhaps the only highlight of my bout with typhoid was meeting an elderly Canadian couple in the Ngorongoro Crater; he was staring intently at my rashes so I hastily informed him it was typhoid and that it wasn't contagious. He wasn't worried about it being contagious though; he'd always been curious about typhoid and despite his wife's embarrassment asked if I'd mind if he just quickly touched it.
"Sure, you can touch my typhoid" is probably one of those phrases I'll never find myself uttering again in this life.
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