Although typhoid was a huge problem during the early stages of the industrialization and urbanization of the United States, the problem has disappeared. What helped the U.S. to overcome typhoid? It was a number of things, including public education and vaccination, but perhaps the most effective improvement is improved sanitation infrastructure. Improved sanitation has the added benefit of decreasing the incidence of multiple other diseases that are spread in the same way such as paratyphoid and Giardia.
Overview of typhoid
Typhoid fever is caused by an infection of Salmonella Typhi, which is related to other forms of salmonella bacteria that are more common in the United States. There are two effective typhoid vaccines in the U.S. (oral and injectable) which last from 2 to 5 years. Typhoid fever symptoms include fever, weakness, stomach pain, and loss of appetite. In severe cases, it can lead to complications such as internal bleeding or pneumonia. It is difficult to discern typhoid from other related illnesses without proper diagnostics and it may even be difficult to properly diagnose with testing, giving the low accuracy of the Widal test which is widely used in developing countries.
Consider how typhoid is transmitted
Typhoid is transmitted indirectly. Rather than through person to person contact, it is usually transmitted through the "oral-fecal route." This means that typhoid is shed through human feces, which is then ingested by others who drink water or eat food contaminated with the bacteria. A few interesting facts about typhoid:
Humans are the reservoir of typhoid. The bacteria may survive outside of the human body for quite a while but it is unlikely to flourish and multiply
Humans can carry it long after recovery despite not having symptoms. It is not typical to carry typhoid and be able to spread it for years after recovery but it is possible in some cases. Such was the case with Mary Mallon, AKA "Typhoid Mary" who was responsible for numerous outbreaks in New York and surrounding areas in the early 1900s.
Unfortunately, raw sewage flows through the streets in many developing nations. This makes it difficult to stop typhoid fever and other diseases transmitted through the oral-fecal route.
Consider how the U.S. overcame typhoid
In its early industrial history, typhoid was a big problem in the United States, causing numerous outbreaks. The United States implemented three things to help stop typhoid:
Improved sanitation infrastructure
Typhoid vaccination campaigns
Public education on hygiene
One of the key factors in the reduction of typhoid fever in the United States was the implementation of better sanitation systems and regulations, particularly in urban areas. This included the construction of sewage systems, the treatment of drinking water, and the regulation of food safety.
Additionally, the use of vaccines played a crucial role in controlling the spread of typhoid fever. The first typhoid vaccine was developed in 1896, and by the early 1900s, it had become widely available. The use of the vaccine, along with improved sanitation and hygiene practices, helped to greatly reduce the incidence of typhoid fever in the United States.
The efforts of public health campaigns and education also contributed to the success in fighting the disease. Once people were educated about the manner of the spread of disease, people took more thought to avoid contamination. Health inspectors went to work fighting poor sanitation in restaurants.
By the mid-20th century, typhoid fever had become relatively rare in the United States, but is still a big problem in Africa and parts of Asia.
Modern sanitation infrastructure
Modern sanitation infrastructure is designed to protect public health and the environment by safely and effectively collecting, treating, and disposing of waste and sewage. Such infrastructure typically includes a combination of systems and technologies that work together to collect, transport, treat, and dispose of waste and sewage.
In developed countries, this means collecting and transporting sewage through an underground system of pipes. Water and sewage systems must be well-maintained and regularly tested to guard against mixing. In addition to a network of pipes to transport both water and sewage, a sewage treatment plant is necessary to avoid discharging contaminated water back into the environment. A proper garbage retrieval and collection system along with landfills closes the loop on the waste side.
The downside of modern sanitation is that landfills are not very sustainable because they don't properly break down the waste over time. New methods are being developed to deal with this issue because the new goal of environmentalism is not just to slow the earth's man-made decline, but to actually regenerate the earth and make it--at least in some ways--better than we found it.
New innovations that are making it possible to have good sanitation in the developing world
Several systems are being developed to purify water or recycle human waste on-site at a small scale without requiring transportation to central facilities. Some of these systems are quite cost-effective as well. Regenerative agriculture is a technique where cows are removed from factory farms and brought back to the fields so that they can be rotated through paddocks in an organized manner to actually regenerate depleted soils through targeted animal impact.