A severe, generalized human disease,
typhoid fever is caused by the bacterium Salmonella typhi, which enters the body in water or
food contaminated with the feces or urine of a carrier of the disease. Chronic carriersÑ2% to 5% of patients who have recoveredÑare the main source of infection. After an incubation period of 7 to 21 days, the illness begins with fever, lethargy, headache, and loss of appetite. Increasing weakness and abdominal discomfort develop during the
second week, when a rose-colored rash may appear. Intestinal bleeding or perforation may
occur in the second or third
week and can be fatal.
Treatment with chloramphenicol or ampicillin has reduced the mortality rate from 30% to 2%. In untreated patients, recovery may begin after about four weeks. Transmission of typhoid fever may occur through food contaminated by polluted water or by food handlers who are carriers. It can be prevented by sanitary disposal of human excreta and by chlorination of drinking water. Injection of a vaccine prepared from killed typhoid bacilli affords moderate short-term protection from the disease.
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