Typhoid infection is a fecal-oral transmissible disease caused by the bacteria Salmonella enterica , serotype S typhi and Salmonella enterica , serotype S paratyphi .
It is seen in developed countries mainly among travelers returning from endemic countries.
Highest incidence is in the Indian subcontinent and, parallel to that, among travelers returning from that area.
Typhoid vaccine does not protect from paratyphoid infection.
Prolonged febrile illness with normal WBC count in returnees from an endemic area should increase suspicion.
Definitive diagnosis is by blood culture.
Presumptive antibiotic treatment in the traveler should depend upon the country of origin.
Typhoid infection is a fecal-oral transmissible disease caused by the bacterium Salmonella enterica , serotype S typhi . A similar clinical syndrome is caused by Salmonella enterica , serotype S paratyphi , and the terms "enteric fever" and typhoid infection are used to describe both diseases. Unless otherwise stated, the information presented here will relate to both diseases ( S typhi and S paratyphi ) described by the term typhoid infection.
Today, most typhoid infections occur in less-developed countries where sanitary conditions remain poor and water supplies are not treated. Humans are the only known reservoir, and transmission occurs through food and water contaminated by acutely ill or chronic carriers of the organism. Typhoid infection is still a major health problem in many developing countries and is far from being eradicated. Although it is no longer endemic in most developed countries, it is seen there in travelers returning from endemic countries, especially from the Indian subcontinent. With the continued increase in worldwide traveling and of migration from endemic regions, physicians should be well acquainted with the disease.
The current vaccines available offer only moderate protection against S typhi and almost no protection against S paratyphi , which has become a more dominant pathogen. Taken together with the increase in multidrug-resistant strains, cases are expected to continue to increase and become ever more challenging to treat.
Center for Geographical Medicine and Tropical Diseases
Chaim Sheba Medical Center
Tel HaShomer Hospital
Clinical Professor of Medicine
Sackler Faculty of Medicine
Tel Aviv University
ES is an author of a number of references cited in this monograph.
Clinical Associate Professor
Weill Medical College of Cornell University
New York Center for Travel and Tropical Medicine
New York City
BAC declares that he has no competing interests.
Senior Lecturer (Honorary Consultant)
Division of Medical Microbiology and Genitourinary Medicine
School of Infection and Host Defence
University of Liverpool
CP declares that he has no competing interests.
Department of Pathology
University of Texas Southwestern Medical Center
PMS declares that he has no competing interests.
Use of this content is subject to our disclaimer