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.

Read more at Wikipedia.org

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Novel typhoid vaccine surpasses old ones - Brief Article
From Science News, 4/28/01 by N. Seppa

Although many people in industrialized countries think of typhoid fever as a scourge of bygone times, the disease strikes more than 16 million people worldwide every year. Adults immunized with the best available vaccines still face a 30 percent risk of contracting typhoid if they come into contact with Salmonella typhi, the bacterium that causes the disease. The vaccines impart even weaker protection to young children.

A study of Vietnamese children 2 to 5 years old now provides the best showing ever for a typhoid vaccine, says study coauthor Feng Ying C. Lin, a pediatrician at the National Institutes of Child Health and Human Development (NICHD) in Bethesda, Md. The new vaccine can slash typhoid risk after contact with the pathogen to less than 10 percent.

Beginning in 1997, Lin and her colleagues gave 11,091 children living in a typhoid-infested area of the Mekong River delta two injections, 6 weeks apart. Half the children received the vaccine, and the others got shots of saline water. Only 4 of those vaccinated contracted typhoid during the next 27 months, compared with 47 of those not vaccinated, the researchers report in the April 26 NEW ENGLAND JOURNAL OF MEDICINE. The disease was milder in the vaccinated children than in the others. A group that had received only one vaccination showed considerable protection as well.

The new vaccine links a sugar molecule found on the surface of S. typhi with a harmless, genetically engineered version of a protein called exotoxin A from another bacterium. This sugar-protein duo arouses the immune system to churn out antibodies against the typhoid bacterium, says study coauthor Shousun C. Szu, a biochemist at NICHD. Three-year data from the study suggest the protection is long lasting, Lin says. Other vaccines elicit lower antibody concentrations and wear off faster, she says.

If the new vaccine also proves effective in babies less than 2 years old, it could play an important role in controlling the disease in areas where it is endemic, says Richard L. Guerrant of the University of Virginia in Charlottesville. He also expects the vaccine to protect older children and adults.

Typhoid spreads when bacteria in feces contaminate drinking water or food. The partial effectiveness of a single vaccination means quick distribution of the new vaccine could slow the disease's spread during outbreaks, Lin says.

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