Typhoid fever is a bacterial illness which affects more than 21 million people worldwide each year. Though usually not lethal in developed nations, the mortality rate in countries without adequate medical options is substantial. The bacterium responsible for this condition, Salmonella typhi is transmitted through the fecal-oral route. One of the largest factors contributing to the spread of typhoid fever is insufficient hygiene among food handlers. For this reason, many countries have instituted campaigns to instruct those in the food industry to wash their hands after using bathroom facilities.
It is estimated that around 5% of those who contract typhoid fever may continue to transmit it after they stop exhibiting symptoms. Historically, the most famous carrier is undoubtedly Typhoid Mary of New York. She was allegedly responsible for passing on the illness to more than three-hundred people during her time as a cook.
Typhoid fever may be treated and prevented through the use of a number of antibiotics. When properly treated, the mortality rate is just below 1%, making this condition a low-level threat for those in the developing world. Most cases of the illness, however, are contracted abroad, often in countries with an insufficient medical structure to treat the condition. If left untreated, the mortality rate rises to around 20%.
Typhoid fever is common throughout the developing world, particularly prevalent in Africa, Asia, and Latin America. Travelers to these locations are often advised to receive a vaccine prior to visiting, though carefully watching what one eats and drinks while traveling is equally important, as the vaccine does not fully protect. Boiling all water, avoiding ice, eating only fruits and vegetables that are peeled, peeling one's own food, staying away from street food, and eating only foods that are fully cooked and still hot are a few recommendations for lowering the likelihood of contracting typhoid fever while in an at-risk country.
The primary symptoms of typhoid fever are a high sustained fever, recurring headaches, loss of appetite, and weakness. A spotty rash may also exhibit on some people who are infected, though this should not be depended on for identification. Because of the relatively common nature of symptoms, it is usually impossible to diagnose this condition based on observation alone. Blood or stool tests are usually required to test for the existence of Salmonella typhi.
Once diagnosed, a carrier will be started immediately on a course of antibiotics, usually ciprofloxacin, trimethoprim-sulfamethoxazole, or ampicillin. The healing process is fairly rapid, with most patients exhibiting great recovery within only a couple of days. Those who have contracted typhoid fever, even once they have been treated and symptoms have disappeared, may still carry the bacteria. For this reason, it is important to continue taking one's antibiotics, to observe careful hygiene, and to refrain from preparing or serving food of any kind. After some time has passed, a follow-up test for the presence of Salmonella typhi should be taken to determine whether the bacteria is entirely gone from the body.