Typhoid fever is a life-threatening illness caused by the bacterium Salmonella Typhi. In the United States about 400 cases occur each year, and 75% of these are acquired while traveling internationally. Typhoid fever is still common in the developing world, where it affects about 21.5 million persons each year. Typhoid fever can be prevented and can usually be treated with antibiotics.

Worldwide, the number of typhoid cases for 2000 was estimated at 17 million with 600,000 deaths, although this is considered to be a very conservative number. In the U.S., about 400 cases occur each year; most are acquired while traveling internationally.

There are currently two vaccines available for typhoid fever. However, because the vaccines are not completely effective, good personal hygiene, including frequent handwashing, and precautions with food and water (see below) are also important.

If you (and others) are traveling to countries where typhoid is present, consider getting vaccinated (consult a healthcare professional or travel clinic about age requirements and waiting time before it becomes effective) and follow sanitary precautions during the trip. Someone diagnosed with typhoid fever may still pass the infection on to others, even after the symptoms disappear. To minimize this risk: Avoid serving foods to other, whether at home or job setting.

Typhoid fever is diagnosed by isolating the bacteria from blood, urine, or stool. Stool samples may also be taken from members of the patient's family to identify any 'healthy' carriers.

Typhoid fever symptoms may be mild to severe and include gradual onset of sustained fever, headache, nausea, loss of appetite, constipation or sometimes diarrhea, and rose-colored spots on the trunk. Symptoms generally appear one to three weeks after exposure. Relapses are possible. Complications include inflammation of the membrane that lines the wall of the abdomen and the abdominal organs (peritonitis), bleeding and perforation of the intestines, and kidney failure.

Anyone can get typhoid fever, but the greatest risk is to travelers visiting countries where the disease is common.

Typhoid fever is transmitted by food and water contaminated by the stool and urine of patients and carriers. Polluted water is the most common source of typhoid. Other sources of infection have been shellfish taken from sewage-contaminated beds and eaten raw, contaminated foods, and contaminated milk and milk products.

Specific antibiotics such as chloramphenicol, ampicillin, or ciprofloxacin are often used to treat cases of typhoid. Treatment and completion of treatment are important. P ersons who do not get treatment may continue to have fever for weeks or months . Some excrete bacteria in their stool for up to three months and a small portion of untreated patients become permanent carriers.

Salmonella Typhi lives only in humans. Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. In addition, a small number of persons, called carriers , recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed S. Typhi in their feces (stool). You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding S. Typhi or if sewage contaminated with S.

Typhoid fever is common in most parts of the world except in industrialized regions such as the United States, Canada, western Europe, Australia, and Japan. Therefore, if you are traveling to the developing world, you should consider taking precautions. Over the past 10 years, travelers from the United States to Asia, Africa, and Latin America have been especially at risk.

It may surprise you, but watching what you eat and drink when you travel is as important as being vaccinated. This is because the vaccines are not completely effective. Avoiding risky foods will also help protect you from other illnesses, including travelers' diarrhea, cholera, dysentery, and If you drink water, buy it bottled or bring it to a rolling boil for 1 minute before you drink it. Bottled carbonated water is safer than uncarbonated water.

Persons with typhoid fever usually have a sustained fever as high as 103° to 104° F (39° to 40° C). They may also feel weak, or have stomach pains, headache, or loss of appetite. In some cases, patients have a rash of flat, rose-colored spots. The only way to know for sure if an illness is typhoid fever is to have samples of stool or blood tested for the presence of S. Typhi .

Typhoid fever is common in most parts of the world except in industrialized regions. Over the past 10 years, travelers to Asia (particularly the Indian subcontinent), Africa, and Latin America have been especially at risk. The risk is greater for those who travel to developing countries and who travel in smaller cities, villages, and rural areas off the usual tourist routines. To minimize your risk: Drink only water that you have boiled or treated with chlorine or iodine.

Fever is the first weapon in the arsenal used when foreign substances invade a body. Chemicals released by the foreign substances stimulate the hypothalamus to increase the body temperature. The hypothalamus is the "thermostat" of the body. The hypothalamus can raise or lower body temperature through chemical signals to other systems to make the changes necessary. A fever is the response to foreign substances, bacteria or viruses in the body. Fever has benefits.

Describe your symptoms to your health care provider, and do not forget to mention your travel history.

Pontiac Fever is a flu-like illness caused by the same bacterium as Legionnaire's disease. It is self-limiting (people get well on their own in a few days) and no one knows why some infections manifest as the one disease and some as the other.