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Everything you need to know about typhoid fever for international travel

Typhoid fever, also known simply as typhoid, is an infectious disease caused by the bacterium Salmonella typhi. This bacterial disease is related to other salmonella bacterial diseases that are more common in the U.S. Because it is a bacteria it can be treated with antibiotics. There is a safe and effective typhoid vaccine.

What are the symptoms of typhoid fever?

The symptoms of typhoid fever can vary, but typically include:

  • High fever (103-104°F)

  • Headache

  • Weakness

  • Abdominal pain

  • Loss of appetite

  • Constipation or diarrhea

  • Rose-colored spots on the skin (a rash)

  • Enlarged spleen and liver

Symptoms usually appear within 1 to 3 weeks after exposure and can last for several weeks. The fever can be continuous or can come and go. It's possible to not have any symptoms at all but to still be contagious.

In some cases, complications can occur such as intestinal bleeding or perforation, and if left untreated, the disease can be fatal in about 10-15% of cases. It's important to see a doctor if you suspect you have typhoid fever, especially if you have recently traveled to an area where the disease is common.

How is typhoid spread?

Typhoid fever is spread through contaminated food or water. Live typhoid bacteria is shed in the feces of an infected person and can contaminate food or water if sanitation is poor. The disease can also spread through close contact with an infected person, as the bacteria can be present in the blood and urine of people who have the disease.

The most common ways typhoid fever is spread include:

  • Consuming food or water that has been contaminated with the feces of an infected person

  • Eating food handled by an infected person who did not wash their hands properly

  • Close contact with an infected person, such as living in the same house or caring for an infected person

  • Traveling to areas with poor sanitation and inadequate water treatment

How can typhoid fever be prevented?

It's important to practice good hygiene and sanitation, particularly when traveling to areas where typhoid fever is common. This includes washing hands frequently, avoiding risky foods and drinks, and getting vaccinated to reduce the risk of infection.

Who was Typhoid Mary?

"Typhoid Mary" was a nickname given to an Irish-American woman named Mary Mallon. She was the first known healthy carrier of the bacterium Salmonella typhi, the cause of typhoid fever. Mallon was born in 1869 and worked as a cook for various families in New York City.

In 1906, health officials began investigating an outbreak of typhoid fever that had occurred among the staff and guests of a summer home in Oyster Bay, New York. They traced the source of the outbreak to Mallon, who had been working as a cook at the home. She was found to be carrying the bacteria in her gallbladder and was shedding it in her feces, but she had no symptoms of the disease. She was quarantined and forced to give up her job as a cook.

Mallon was released from quarantine in 1910 but was again identified as a carrier and a source of infection in 1915, and was forcibly quarantined until her death in 1938.

Mallon's case was significant because it was the first time health officials had identified a healthy person who could spread the disease without showing symptoms. Her story has been widely used as an example of the importance of public health measures and the need to identify and isolate carriers of infectious diseases.

What are the typhoid vaccine options?

Read "Typhoid pills vs. injection" for more information.

Who should get the typhoid vaccine?

The typhoid vaccine is recommended for people who are traveling to or living in areas where typhoid fever is common, particularly in developing countries with poor sanitation and inadequate water treatment.

The Centers for Disease Control and Prevention (CDC) recommends the typhoid vaccine for people who are traveling to areas where the disease is common, including:

  • Parts of Africa, Asia, and South America

  • Areas with poor sanitation and inadequate water treatment

  • Places where outbreaks of typhoid fever are occurring

Additionally, the vaccine is recommended for people who are at an increased risk of exposure to the disease, including:

  • People traveling for an extended period of time

  • People traveling to visit friends or relatives

  • People traveling for work or study

  • People traveling as part of a tour group

  • People who will be staying in places with limited access to safe food and water

  • People who are planning to hike or camp in remote areas

It's important to consult a healthcare provider before traveling to determine if the typhoid vaccine is appropriate, as well as recommended other vaccinations and preventive measures.


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