Typhoid fever is an illness caused by the bacterium Salmonella typhi. Very common worldwide, it is transmitted by food or water contaminated with feces from an infected person.

Symptoms

After infection, symptoms include:

a high fever from 103° to 104°F (39° to 40°C) that rises slowly
chills
slow pulse rate (bradycardia)
weakness
diarrhea
headaches
myalgia
lack of appetite
constipation
stomach pains
in some cases, a rash of flat, rose-colored spots called "rose spots"

Extreme symptoms such as intestinal perforation or hemorrhage, delusions, and confusion also are possible

Diagnosis

Diagnosis is made by blood, bone marrow or stool cultures and with the Widal test (demonstration of salmonella antibodies against antigens O-somatic and H-flagellar) or, in less affluent countries with the urine diazo test. In epidemics and less wealthy countries, after excluding malaria, dysentery or pneumonia, a therapeutic trial with chloramphenicol is generally undertaken while awaiting the results of Widal test and blood cultures.

Treatment

Typhoid fever can be fatal. Antibiotics, such as ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, and ciprofloxacin are commonly used in treating typhoid fever in the west.

When untreated, typhoid fever persists for three weeks to a month. Death occurs in between 10% and 30% of untreated cases. Vaccines for typhoid fever are available and are advised for persons traveling in regions where the disease is common (especially Asia, Africa, and Latin America).

Transmission

A person may become an asymptomatic carrier of typhoid fever, suffering no symptoms, but capable of infecting others. According to the Centers for Disease Control approximately 5% of people who contract typhoid continue to carry the disease after they recover.

The most notorious carrier of typhoid fever, but by no means the most destructive, was Mary Mallon, also known as Typhoid Mary. In 1907 she became the first American carrier to be identified and traced. She was a cook in New York at the beginning of the 20th Century. Some believe she was the source of infection for several hundred people. She is closely associated with fifty cases and five deaths. Public health authorities told Mary to give up working as a cook or have her gall bladder removed. Mary quit her job, but returned later under a false name. She was detained and quarantined after another typhoid outbreak. She died of a stroke after 23 years in quarantine.

Famous victims

Typhoid fever has touched the lives of several famous people.