Two days ago, Romania registered the first case of typhoid fever this year. It is about a patient hospitalized at the “Victor Babeş” Hospital for Infectious Diseases, who recently returned from Pakistan and who was not immunized against this disease. Last year there were three other patients who got the disease from African countries. Not to mention those who came with malaria. Who pays for their hospitalization and treatment? Because they are settled services, the money comes from our pockets
From last year until now, four cases of typhoid fever have been registered in Romania
The fourth case of typhoid fever has already been registered in Romania, announced the manager of the “Victor Babeş” Hospital for Infectious and Tropical Diseases, Simin Aysel Florescu. It is about a hospitalized patient who returned from Asia. “We already have the fourth case of typhoid fever in the hospital that is acquired from somewhere… the last one, from Pakistan, as if the three previous ones from the Congo. They are all Romanians who have traveled there and who have not been vaccinated“, said the doctor.
What is typhoid fever?
According to the Travel Medicine Society, typhoid fever is an acute, potentially severe infectious disease caused by Salmonella typhi. Bacillus tificus is a bacterium that only infects humans. The source of the infection is the patient (during his illness, in convalescence or the healthy bile carrier). The infection is transmitted through consumption of contaminated food or water.
Severe cases are characterized by fever that starts gradually, headache, altered state, anorexia and insomnia. Constipation is more common than diarrhea in adults and older children. Without treatment, the disease progresses with persistent high fever (39-40 degrees Celsius), digestive symptoms and sometimes pneumonia. In up to 50% of cases, a rash appears, more visible on light-colored skin. The spots are arranged mainly on the trunk. In the third week of the disease, in the absence of treatment, complications may occur, some of which may be fatal: digestive perforations, peritonitis, hemorrhages. Approximately 2%-5% of patients become chronic carriers, in which the bacterium persists in the biliary tract after the disappearance of clinical symptoms. After World War II, typhoid fever was eradicated throughout Europe. Now we are only talking about sporadic cases.
12,000 lei for 5 days of hospital treatment
Because we are talking about a condition that could be prevented by vaccination, it is natural to ask how much money is needed for the hospitalization and treatment of a sick person. Money that is raised from the taxes we all pay.
“If we are talking about a mild form, the treatment itself does not cost who knows what. The antibiotics that are given are not very expensive. They work on Salmonella typhi, but they are relatively cheap: ampicillin, biseptol, tetracycline… they don't cost who knows what. If I go online to see how much the biseptol pill costs, it is at a different price than the hospital buys it at. Because we buy them by auction and at lower prices. We, for example, buy the ampicillin pill for 50 money. Obviously, if the patient has a severe form and complications, then the costs increase exponentiallyl”, Cătălin Apostolescu, the manager of the “Matei Balș” Hospital in the capital, stated for “Adevărul”.
The treatment is fully settled by CNAS. “We settle the medical services and medicines that the hospital consumes for the treatment of a patient, regardless of the condition. We settle on a settled case. That means the total cost to solve a health problem. The hospital gives us the CNP of the patient for whom it requests the settlement, and the Health Center makes the payment“, explained, for “Adevărul”, Cristina Călinoiu, spokesperson of CNAS. Statements are made monthly. “The hospital reports monthly to the House the services offered to citizens that are included in the service package and the House pays them“, Cristina Călinoiu also specified.
Therefore, if the treatment is relatively cheap, the same cannot be said about the hospital day. At the “Matei Balș” Hospital for Infectious Diseases, for example, one day of hospitalization costs 2,200 lei. “To this amount is added the cost of tests and the treatment that the patient receives depending on the condition. If we had a typhoid fever patient hospitalized for 5 days, say, the costs would reach somewhere around 12,000 lei. However, we are talking about cases that are not complicated”said Dr. Cătălin Apostolescu.
What goes into this amount? “Water, electricity, sewage, food, doctors', nurses', and nurses' salaries, don't let anyone think that a hospital day is calculated as a hotel day“, also said the manager of the “Matei Balș” Hospital. “Being a vaccine preventable disease, and we should not have such cases“, this is his opinion. And, we say, we shouldn't pay for them.
The cost of the vaccine
How much does the vaccine cost? For example, if you buy it from the pharmacy, it costs slightly more than 100 lei. If you choose to get vaccinated at the Diagnostic and Treatment Medical Center “Dr. Victor Babeş”, you will pay 135 lei. It's not the end of the country compared to the price of hospitalization in case of illness.
Typhoid vaccination is not mandatory for people traveling abroad. It is, however, recommended when visiting areas where the infection is endemic, especially when traveling in small towns, in rural areas outside the tourist routes, where food and water could be contaminated.
