Typhoid, also known as enteric fever, is a bacterial infection caused by the salmonella typhi bacterium. Typhoid affects about 21 million people worldwide and kills about 200,000, according to the Centers for Diseases Control and Prevention. Typhoid is not common in the United States. Most cases are contracted during foreign travel to underdeveloped countries.
Athens Outbreak
An outbreak of typhoid fever around 430 B.C. is believed to have killed one third of the population of Athens, including the statesman and orator Pericles, according to the medical news website New-medical.net. The Greek historian Thucydides was also infected but survived and wrote about the outbreak.
Discovery
Karl Joseph Eberth, a German bacteriologist, identified typhoid in 1880, according to the security website Globalsecurity.org.
The most famous typhoid carrier in American history was Mary Mallon, who worked as a cook in New York. In 1907, she became the first American to be identified as a typhoid carrier. Mallon, popularly known as Typhoid Mary, is believed to have infected 53 people during her career as a cook. Mallon was quarantined for 23 years until her death.
In 1909, an army physician made the first successful typhoid vaccine that reduced soldier mortality rates. In 1942, antibiotics were introduced, which led to further declines in mortality. Most developed countries saw a decline in typhoid during the first half of the 20th century because of the growing availability of vaccine.
Transmission and Symptoms
Typhoid is common in underdeveloped countries where public sanitation is poor. People who travel to developing countries in Africa, Asia and Latin America may discover that they are infected with typhoid when they return home. The National Institutes of Health says that salmonella typhi bacteria are spread by eating contaminated food and drinking contaminated water. When ingested, the bacteria enter the bloodstream, where they multiply and invade the organs. Symptoms usually develop 10 to 14 days after infection. Symptoms include fever, malaise, fatigue, nausea, vomiting, constipation, diarrhea, rose-colored spots on the trunk, enlarged spleen and liver. Patients with advanced typhoid may experience anemia, gastrointestinal bleeding and intestinal perforation.
Treatment
Antibiotics such as ciprofloxacin, ampicillin, trimethoprim-sulfamethoxazole and chloramphenicol are the usual treatment. Ciprofloxacin is generally the first-line treatment. In the past, chloramphenicol was the first-line treatment, but the drug is rarely use these days because of its dangerous side effects and resistance to salmonella typhi. Ampicillin and trimethoprim-sulfamethoxazole are used in cases where ciprofloxacin cannot be used.
Prevention/Solution
According to the Centers for Diseases Control and Prevention, the most effective way to avoid typhoid is to wash hands and avoid contaminated foods and drinks. People traveling to underdeveloped countries where typhoid is common should avoid raw fruits and vegetables from street vendors and may want to avoid street-vendor food altogether. Travelers should drink only bottled water. The Centers for Diseases Control recommends typhoid vaccines for anyone traveling to underdeveloped countries. Vaccines are not 100 percent effective, though, and travelers should continue to observe other preventative measures.
