Typhoid fever is an acute, life-threatening febrile illness caused by the bacterium Salmonella typhi. About 21 million cases of typhoid fever occur each year around with world, with more than 200,000 related deaths. About 400 cases of typhoid fever occur each year in the United States, mostly among travelers. Travel to certain areas of the world puts people at increased risk of exposure to S. typhi. These areas include South Asia, East Asia, Southeast Asia, Africa, Caribbean, Central America, and South America.
People infected with S. typhi shed the bacteria in their urine and feces. S. typhi can also be found in an infected person's blood. Most people become infected through consumption of water or food that has been contaminated by the feces of a person who is shedding S. typhi. About 10% of people infected with typhoid remain infectious for up to 3 months, if not treated. In addition, up to 4% of people become chronic carriers. Carriers no longer have symptoms, but are capable of infecting others.
Symptoms of typhoid fever begin about 1 to 3 weeks after exposure. Common symptoms include sudden onset of a sustained fever as high as 39.4°C to 40°C (103°F to 104°F), myalgia (muscle pain), severe headache, fatigue, weakness, nausea, abdominal pain, severe anorexia, and constipation. Some people with typhoid fever also may have a characteristic flat, rose-colored rash on the abdomen and chest during the second week of fever. Severe typhoid fever can progress to swelling of the liver and spleen, intestinal hemorrhage and/or perforation, pericarditis, and sometimes meningitis or inflammation of the joints. Without treatment, people can continue to have fever for weeks or months. The death rate from complications can be as high as 30%.
Treatment for typhoid fever includes supportive care, usually in a hospital, and antibiotics. In addition, people who handle food or care for small children may be required to stay away from work until lab tests show that they no longer carry the bacteria.
There are two typhoid vaccines. One is an oral, live attenuated
vaccine (Vivotif®). The other is an injected, inactivated vaccine
Product: Typhim Vi® (Inactivated Typhoid Vaccine)
Manufacturer: Sanofi Pasteur
Year licensed: 1994
Product Name: Vivotif® (Live Typhoid Vaccine)
Year licensed: 1989