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Typhoid
Typhoid is a bacterial illness spread by contaminated food and water. There are 17 million cases per year, with 600,000 deaths.

This bacterium lives only in people and contaminated food or drinking water. The more bacteria ingested the sicker a person may get. Typhoid vaccines are available but are only about 80% effective and the immune system can be overwhelmed if ingested with a very large dose of typhoid.

Symptoms occur after about 2 weeks and gradually worsen after another 2 weeks. High fever, headaches, stomach ache, anorexia, and constipation (and or diarrhea), coughing, and deafness can occur. Rose spots may develop on the trunk. Diarrhea usually occurs on the second week. In extreme cases meningitis and coma may occur.

Other complications include: increased bleeding, pneumonia, deep vein thrombosis, joint pain, and bone infections. Mortality is about 10% in untreated cases and 1% in treated cases.

Diagnosis is with blood tests. Treatment includes fluids and antibiotics. After symptoms resolve, people should be reviewed to make sure they are not carriers.

Typhoid causes 600,000 deaths annually in developing countries. Presently there is emerging resistance to previously used antibiotics. Vaccination is recommended in the face of increasing drug resistances, increasing incidence, and a high cost benefit for the traveller since illness will last 4-8 weeks (as compared with cholera which will be over in4-5 days). The vaccine may be given with yellow fever vaccine. Paratyphoid is a separate disease from typhoid in which the vaccine is not effective.

Typhoid links

 

Center for Disease Control http://www.cdc.gov/ncidod/dbmd/diseaseinfo/typhoidfever_g.htm

 

History 1900 Typhoid Mary http://history1900s.about.com/library/weekly/aa062900a.htm

 

World Health Orgaization http://www.who.int/health_topics/typhoid_fever/en/