Disease Spotlight: Typhoid Fever

By Samhar Almomani on May 2, 2022

Typhoid and paratyphoid fever are both fatal, life-threatening diseases caused by Salmonella Typhi and Salmonella Paratyphi bacteria. The bacteria can be spread by consumption of contaminated food or water and affects an estimated 11-21 million people worldwide every year. Although the disease is rare in the United States, it is very common in other parts of the world. Symptoms of the fever include weakness, headache, loss of appetite, diarrhea or constipation, stomach pain and high fever. Sometimes, people who are infected have a cough or rash. In some rare cases, internal bleeding and death can occur (Source: CDC).

Typhoid and paratyphoid fever can be found in many parts of the world, including South and East Asia, Africa, the Caribbean, Central and South America, and the Middle East. Approximately 425 people are diagnosed with typhoid and 125 with paratyphoid fever in the United States every year, often after traveling outside of the United States.

Blood culture is usually the main way to diagnose the disease, and early diagnosis and resistance testing can ensure that the right antimicrobial treatment is effective and started early in the course of the disease. Since typhoid and paratyphoid fever are considered a notifiable disease, the local or state health departments are informed of those infections. One consideration is that the treatment differs depending on the strain of the fever. For example, patients who traveled to South Asia are infected with strains not susceptible to fluoroquinolones. Therefore, obtaining a travel history is important to correctly treat the disease. With that being said, there are ways to prevent an infection. The CDC recommends vaccination for travelers going to countries where typhoid fever is endemic, such as South Asia, especially Pakistan, India, or Bangladesh. There are currently two vaccines available in the United States: 1) An oral vaccine can be given to people who are at least 6 years old and consists of taking four pills every other day and 2) an injectable vaccine that can be given to people at least two years old. The vaccines protect 50%-80% of people who are vaccinated. The injectable vaccine needs a booster every two years, and the oral vaccine needs a booster every five years. However, there is currently no vaccine for paratyphoid fever. Other ways to prevent an infection would be to make sure not to drink water that is not bottled, boiled or treated to remove germs. Travelers should also avoid eating salads, uncooked vegetables, raw fruits and unpasteurized fruit juices. Food should be fully cooked and consumed hot, as per the traveling guidelines set by the CDC.

It is also important to look into the disease’s burden, especially the fact that it affects low-income communities that lack sanitary water. “Despite notable progress, typhoid and paratyphoid fevers remain major causes of disability and death, with billions of people likely to be exposed to the pathogens,” read an article published in the Lancet. The article notes that it is important to ensure improvements in water and sanitation, but an increase in vaccine use and improved global surveillance is likely to result in the most improvement in the global burden of the disease. At World Forgotten Children Foundation (WFCF), we aim to ensure access to sanitary water so that underprivileged communities remain healthy. Help our mission by donating to WFCF today!

Sources:

https://www.cdc.gov/typhoid-fever/pdf/TyphoidFeverGeneral-B-Typhoid-Paratyphoid-Fever_508.pdf

https://www.cdc.gov/typhoid-fever/pdf/TyphoidFeverPhysicians-A-Information-for-Healthcare-Professionals_508.pdf

https://pubmed.ncbi.nlm.nih.gov/30792131/

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