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Typhoid Fever


What is Typhoid Fever?


Typhoid fever, a salmonella infection, is a serious disease caused by a bacterium, not a virus. The germ is called Salmonella Typhi. Most Americans who contract this disease acquired the infection while traveling abroad. This is a common infection in the developing world.


How is typhoid fever spread?

Infected individuals carry the typhoid germ in their blood stream or in their intestines. New infections develop when a healthy individual ingests contaminated food or beverages. If a restaurant handler is contaminated, or if food comes in contact with contaminated surfaces, then restaurant guests can become infected. This is why typhoid is more common in regions with poor sanitation and hygiene. The disease is transmitted through the fecal-oral route, because infected persons shed the germ in their stool, which is passed to their hands in the restroom, and is ultimately ingested by another person, who may then contract typhoid.


What are the symptoms of typhoid fever?

Typical symptoms include high fever, weakness, abdominal pain, and headache. A rash develops in some individuals. There is a 30% mortality rate if the disease is not properly treated.


How is typhoid fever diagnosed?

There are special blood and stool tests to diagnose typhoid. If a physician is fairly certain that the diagnosis is typhoid, antibiotics may be prescribed before the results of testing are available. Often, treatment may be prescribed without any diagnostic testing, if the symptoms are typical of typhoid and the disease is common in the region of travel.


Is treatment available?

Standard treatment is antibiotics. It is very important to take the entire course of antibiotics prescribed by your doctor. In addition, during treatment, you may still be infectious, so you should wash your hands thoroughly after using the rest room and avoid preparing food to be served to others. Some individuals who recover from typhoid continue to carry the germ in their intestines. These carriers of the disease are not ill, but they can infect others.


Can typhoid fever be prevented?

Yes. There are two effective strategies to reduce your risk of contracting typhoid. First, make sensible food and beverage choices. Local health authorities may know of restaurants and other establishments to avoid in your destination. Second, obtain a typhoid vaccination before departure. There is an oral and an injectable typhoid vaccine, and both need time to stimulate immunity. So, make sure you see your Travel Clinics of America physician weeks before departure. If you did receive typhoid vaccine in the past, you may need a booster shot. Antibiotics will not prevent typhoid, and they are not recommended.


Do international travelers need to be protected?

Yes. International travelers going to the developing world should discuss typhoid vaccine with their Travel Clinic of America physician weeks before departure. Typhoid is common in South Asia, Africa, the Caribbean, and Central and South America. The vaccine is not a guarantee of protection, so travelers are strongly urged to make wise food and beverage choices to reduce their risk of typhoid.


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