TYPHOID

Typhoid fever is an acute, systemic infection that represents an important cause of morbidity and mortality in the developing world with nearly 22 million cases and 200,000 deaths annually worldwide. (6)

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Key facts

  • Typhoid fever is a serious disease spread by contaminated food and water, caused by the bacterium Salmonella enterica serotype Typhi (6)
  • An estimated 22 million cases of typhoid fever and 200,000 related deaths occur worldwide each year (6)
  • Infection may be confused with many other diseases, main symptom is persistent fever (4)
  • Up to 10% of typhoid patients may develop serious complications (4)
  • Case fatality rate: 10-20% of typhoid patients without antibiotic treatment (4)

What is Typhoid?

Typhoid fever is an acute, life-threatening, febrile illness resulting from infection by the bacterium Salmonella enterica serovar Typhi (S. Typhi). S. Typhi which is only infectious to humans, is highly invasive. (6)
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Where does Typhoid occur?



Adapted from Crump et al. The global burden of typhoid fever.
Bulletin of the World Health Organisation 2004:82:346-53


Regions with a high incidence of typhoid fever (in excess of 100 cases annually per 100,000 people) include south and central Asia and Southeast Asia. Regions of medium incidence (10–100 cases annually per 100,000 people) include the rest of Asia (including countries of the former Soviet Union),(4) Africa, Latin America, the Caribbean and Oceania (excepting Australia and New Zealand). Europe, North America and the rest of the developed world have a low incidence of typhoid fever (less than 10 cases annually per 100,000 people). (2)

Who is at risk of contracting Typhoid?

Travelers to regions endemic for typhoid fever also constitute a major group at risk for the disease. A study in the US on the cases of reported typhoid fever in New York between 1980 and 1990 showed that 67% of cases of the disease were travel-related. (3)

What are the symptoms of Typhoid?

The acute generalized infection of the reticuloendothelial system, including the intestinal lymphoid tissue, kidney and gallbladder, and intermittent bacteremia caused by S. Typhi, can lead to a broad spectrum of clinical illness, most commonly flu-like symptoms with persistent fever.

Clinical symptoms of typhoid fever include: persistent fever, rose spots, malaise, chills, headache, abdominal discomfort, constipation in adults or diarrhea in children and HIV patients, convulsion in children, anorexia, nausea and myalgia. (4)

How can Typhoid be treated?

Supportive measures such as: oral or intravenous hydration, and use of antipyretic drugs are important in the treatment of typhoid fever. Appropriate nutrition and blood transfusions may also be indicated. More than 90% of patients can be treated at home with oral antibiotics, reliable care and close medical check-up for complications or failure to respond to therapy. (1) However, patients with persistent vomiting, severe diarrhea and abdominal distension may require hospitalization and parenteral antibiotic therapy. (5)



References

  1. Committee to Advise on Tropical Medicine and Travel (CATMAT). Statement on overseas travellers and typhoid. Can Commun Dis Rep 1994; 20: 61–2.
  2. Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ 2004; 82: 346–53
  3. Mathieu JJ, Henning KJ, Bell E, Frieden TR. Typhoid fever in New York City, 1980 through 1990. Arch Intern Med 1994; 154: 1713–8
  4. Background document: The diagnosis, treatment and prevention of typhoid fever. PDF
  5. Punjabi NH. Typhoid fever. In: Rakel RE, editor. Conn’s Current therapy. Fifty-second edition. Philadelphia: WB Saunders; 2000. p.161-5
  6. cdc.gov

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