Welcome to Bengaluru

Join Suresh, a teenager from colonial Bangalore, on a journey through space and time to explore the many faces of typhoid fever in Bengaluru.

Click on different parts on the map, to learn about the signs and symptoms of typhoid, how to treat it, and how to prevent it. This map will follow Suresh's journey through the city from illness to health!  

What is Typhoid?

Typhoid is a bacterial infection caused by Salmonella typhi. There are various ways in which the bacteria can move from contaminated faeces and urine to your body, mainly through food and water.

Can you find the Pettai where Suresh lives on the map? (hint: look for number 1 on the map, zooming in and out using the +/- buttons or your cursor)

The history of Bengaluru under Imperial British rule is a tale of a deeply divided city. In 1809 the British established their cantonment (military base) near the Ulsoor tank. Development occurred around the cantonment to the neglect of the two Pettais (villages) that formed the old city. British Imperial officials blamed the unsanitary living conditions in "native" settlements for the outbreaks of diseases such as Typhoid. In truth, poor water and sanitation infrastructure was present in both parts of the city and was worsened by severe water shortages. Typhoid did not discriminate between nationalities, castes or wealth. It touched the lives of all inhabitants of imperial Bengaluru in some form.

Prevention

Although Suresh's story happened more than 100 years ago there are still children and adults that suffer from Typhoid Fever today. The legacy of colonial urban planning can still be seen in modern Indian cities like Bengaluru. This legacy can be seen in the neat grid-like urban planning in some areas and haphazard narrow streets in others with inconsistent access to water and sanitation.

Vaccination against salmonella bacteria can prevent typhoid fever however, vaccines provide protection for a short duration as their effectiveness wanes over time. There are currently three different types of vaccines available against typhoid fever. Vaccination is an essential aspect of Typhoid prevention. Other simple individual and broader structural measures we can take to prevent contracting and spreading Typhoid Fever are:

1. Wash hands well and often. Wash with soap and clean, warm water, especially after using the bathroom or before eating or preparing food. If soap and water aren't available, use an alcohol-based hand sanitizer. This will prevent cross-contamination, lower your ability to transmit typhoid if you’ve been infected, and protect you if you’ve been in contact with an infected person.

2. Wash fruit and vegetables thoroughly. Unpeeled and especially, raw fruits and vegetables such as lettuce and berries should be thoroughly washed with clean water. They may carry salmonella bacteria from contaminated water or have been handled by someone who has typhoid fever.

3. Cook all food. Fully cook all food, and avoid food from street vendors and food stored or served at room temperature. It provides a terminal defense against ingesting typhoid bacteria and other disease organisms that infect our bloodstream and intestinal tract.

4. Water Purification. Boil or disinfect any water that will be used for drinking, washing or preparing food, or brushing teeth. It improves the safety of drinking water and destroys any salmonella bacteria that may have contaminated your water source.

5. Preserve sewage and sanitation facilities. Maintain good sanitary practices and avoid sewage contamination. Sewage contaminated with salmonella bacteria can cause typhoid fever by polluting water used for drinking or cooking food.

How much did you learn from Suresh's story and your exploration of colonial Bangalore? Let's play the Myths and facts quiz and put your knowledge to the test!

Reference List

Appiah GD, Chung A, Bentsi-Enchill AD, et al. (2020) Typhoid Outbreaks, 1989–2018: Implications for Prevention and Control. The American Journal of Tropical Medicine and Hygiene 102(6). The American Society of Tropical Medicine and Hygiene: 1296. DOI: 10.4269/AJTMH.19-0624.

Balaji V, Kapil A, Shastri J, et al. (2018) Longitudinal Typhoid Fever Trends in India from 2000 to 2015. The American Journal of Tropical Medicine and Hygiene 99(3 Suppl). The American Society of Tropical Medicine and Hygiene: 34. DOI: 10.4269/AJTMH.18-0139.

CDC. Symptoms and Treatment | Typhoid Fever |, 2019. URL https://www.cdc.gov/typhoid-fever/symptoms.html (accessed 3.8.22).

Divyashree S, Nabarro LEB, Veeraraghavan B, et al. (2016) Enteric fever in India: current scenario and future directions. Tropical Medicine & International Health 21(10). John Wiley & Sons, Ltd: 1255–1262. DOI: 10.1111/TMI.12762.

Dowshen S, editor. Typhoid fever (for parents) - nemours kidshealth [Internet]. KidsHealth. The Nemours Foundation; 2017 [cited 2022Mar4]. Available from: https://kidshealth.org/en/parents/typhoid.html

Healthline. Typhoid: Symptoms, Causes, and Vaccination, 2016. URL https://www.healthline.com/health/typhoid#vaccination (accessed 3.8.22).

Kirchhelle C, Dyson ZA and Dougan G (2019) A Biohistorical Perspective of Typhoid and Antimicrobial Resistance. Clinical Infectious Diseases 69(Supplement_5). Oxford Academic: S388–S394. DOI: 10.1093/CID/CIZ556.

Mayo Clinic. Typhoid fever - Symptoms and causes, 2020. URL https://www.mayoclinic.org/diseases-conditions/typhoid-fever/symptoms-causes/syc-20378661 (accessed 3.8.22).

PK S, R R, Y H, et al. (2009) Risk factors for typhoid in Darjeeling, West Bengal, India: evidence for practical action. Tropical medicine & international health : TM & IH 14(6). Trop Med Int Health: 696–702. DOI: 10.1111/J.1365-3156.2009.02283.X.

Vanderslott S, Phillips MT, Pitzer VE, et al. (2019) Water and Filth: Reevaluating the First Era of Sanitary Typhoid Intervention (1840–1940). Clinical Infectious Diseases 69(Supplement_5). Oxford Academic: S377–S384. DOI: 10.1093/CID/CIZ610.

World Health Organisation. Typhoid, 2018 URL https://www.who.int/news-room/fact-sheets/detail/typhoid (accessed 3.8.22).

Images Used in Map

Caine, William Sproston (1890).  Picturesque India: A Handbook for European Travellers . London: London and G. Routledge & Sons, Limited. p.  523 

Goddess Maramma. Hindu Blog, 2019.

Ulsoor Lake: Ulsoor Lake: This Man-Made Paradise Is Dying a Slow and Painful Death The Economic Times, 2016.

 The Cantonment Side of Bangalore" . Chronicles of the London Missionary Society. 1890

Bangalore Lady Curzon Hospital. Unknown author, Public domain, via Wikimedia Commons. 1864

Vivotif Typhoid live oral vaccine Kristoferb, Public domain via Wikimedia Commons. 2014