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Typhoid fever is caused by the bacterium Salmonella typhi. In the United States, about 400 cases occur each year, and about 70% of these are acquired while traveling internationally. Typhoid fever is common in the developing world, where it affects about 12.5 million people every year.
- What it is: Typhoid fever is a bacterial disease that is mainly found in developing countries. In the United States, travelers are typically the only ones affected. Typhoid fever is also known as enteric fever.
Transmission: People carry typhoid fever in their bloodstream and intestinal tract. The disease can be spread if an uninfected person comes in contact with an infected person's bodily discharges. Typhoid fever can rapidly spread when infected people handle food or beverages.The disease may also be spread when the S. typhi bacteria contaminates water used for drinking or washing food. These incidents normally occur in parts of the world where hand washing is less common and where water is more likely to be contaminated with sewage.
- Symptoms: Early symptoms are headache, general weakness, aches and pains, and nosebleeds. Constipation may also occur. Within a few days to a week, the patient may run a high fever. During this time, the patient may develop a rose-colored rash, appearing on the abdomen, chest or back.
Prevention: Typhoid fever is common in the developing world. Travelers should be vaccinated against typhoid fever when traveling to places such as Africa, some parts of Asia, and Latin America. You must receive the vaccine at least one week before you travel for the vaccine to take effect. The typhoid vaccine can become less effective over the years, so check with your doctor if your vaccination is not current.
Travelers should avoid all risky food and drink; that is, water that does not come from a bottle or is not boiled, and food such as fruits and vegetables that may have been washed in such water.
The Centers for Disease Control and Prevention guideline for travelers is "Boil it, cook it, peel it or forget it." Other recommendations are:
- If you drink water, buy it bottled or bring it to a rolling boil for a full minute before you drink it. Bottled carbonated water is safer than uncarbonated water.
- Ask for drinks without ice unless the ice is made from bottled or boiled water. Avoid popsicles and flavored ices that may have been made with contaminated water.
- Eat only foods that have been thoroughly cooked and that are still hot and steaming.
- Avoid raw vegetables and fruits that cannot be peeled. Vegetables like lettuces are easily contaminated and very hard to wash well.
- When you do eat raw fruits and vegetables, peel them yourself after washing your hands with soap.
- Avoid foods and drinks from street vendors. Many travelers get sick from food bought on the street.
Treatment: Antibiotics are used to treat the disease. With treatment, deaths rarely occur.It is important to note that even if your symptoms do go away, you could still carry the disease, and so you should have your doctor make sure you no longer carry typhoid fever.