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Definition

Typhoid fever, also known simply as typhoid, is a bacterial illness caused by

Salmonella typhi.[1]

Onset of illness

Symptoms typically begin, six to thirty days after exposure to food or water, contaminated with the feces of an infected person.[2]

Symptoms

Early symptoms may vary from mild to severe.[3][4] Usually, there is a gradual onset of a high fever over several days;[3] weakness, abdominal pain, constipation, headaches, and mild vomiting.[4][5]

Other symptoms

Some people will develop a skin rash, with rose colored spots.[4]

Severe cases and carriers

In severe cases there may be confusion.[5] Without treatment, symptoms may last weeks or months.[4]

Carriers

Other people may carry the bacterium without being affected; however, they are still able to spread the disease to others.[2]

Causes

The cause is the bacterium Salmonella Typhi, that grows in the

intestines and blood.[4][5]

Spread

Typhoid is spread by eating or drinking food or water contaminated with the feces of an infected person.

Risk factor

Risk factors include poor sanitation and poor hygiene.[1]

Risk factor 2

Those who travel in the developing world are also at risk.[5]

Diagnosis

Because symptoms are similar to those of many other infectious diseases,

culturing the bacteria, or detecting the bacterium's DNA in the blood, stool, or bone marrow.[4][1][6]

Bone marrow testing

Culturing the bacterium can be difficult, so [7] bone marrow testing is the most accurate.[6]

Prevention

The chlorination of public drinking water led to the sharp reduction of typhoid in developed nations.[8] In typhoid-endemic countries,

Typhoid vaccines have been shown to prevent 40 to 90% of cases during the first two years,[9] and may have some effect for up to seven years.[1]

Travel to endemic areas

Vaccination is recommended for those at high risk, or people traveling to areas where the disease is common.[2]

Other efforts

Other efforts to prevent the disease include providing clean

handwashing.[4][2]

Infected persons quarantine

Until it has been confirmed that an individual's infection is cleared, the individual should not prepare food for others.[4]

Treatment

The disease is treated with

third generation cephalosporins.[1]

Resistance

Resistance to these antibiotics has been developing, which has made treatment more difficult.[1][10]

Epidemiology

In 2015, there were 12.5 million new cases worldwide.[11]

Epidemiology - geography

The disease is most common in India.[1]

Epidemiology - demographic

Children are most commonly affected.[1][2]

Prognosis

Rates of disease decreased in the

developed world in the 1940s, as a result of improved sanitation, and use of antibiotics to treat the disease.[2]

Risk of death

The risk of death may be as high as 20% without treatment, and 1 to 4% with treatment.[2]

History

The most notorious carrier of typhoid fever, but by no means the most destructive, was Mary Mallon, also known as Typhoid Mary.

History 2

In 1907, she was the first typhoid carrier identified and traced, while working as a cook in New York. She was associated with 53 cases and three deaths.[12]

History 3

She died of pneumonia after 26 years in quarantine.

References

  1. ^
    PMID 25458731
    .
  2. ^ (PDF) from the original on April 2, 2015.
  3. ^ from the original on 2015-07-02.
  4. ^ a b c d e f g h "Typhoid Fever". cdc.gov. May 14, 2013. Archived from the original on 6 June 2016. Retrieved 28 March 2015.
  5. ^ a b c d e "Typhoid Fever". cdc.gov. May 14, 2013. Archived from the original on 2 April 2015. Retrieved 28 March 2015.
  6. ^
    PMID 20014951
    .
  7. from the original on 2017-02-28.
  8. ^ Leal, John L. (1909). "The Sterilization Plant of the Jersey City Water Supply Company at Boonton, N.J." Proceedings American Water Works Association. pp. 100–9.
  9. PMID 29851031
    .
  10. .
  11. PMID 27733282. {{cite journal}}: |first1= has generic name (help)CS1 maint: numeric names: authors list (link
    )
  12. ^ "Nova: The Most Dangerous Woman in America". Archived from the original on 2010-04-26.