Typhoid fever

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Causes

By Mayo Clinic staff

Typhoid fever is caused by a virulent bacterium called Salmonella typhi. Although they're related, this isn't the same as the bacteria responsible for salmonellosis, another serious intestinal infection.

Fecal-oral route
The bacteria that cause typhoid fever spread through contaminated food or water and occasionally through direct contact with someone who is infected. In developing nations, where typhoid is endemic, most cases result from contaminated drinking water and poor sanitation. The majority of people in industrialized countries pick up the typhoid bacteria while traveling and spread it to others through the fecal-oral route.

This means that S. typhi is passed in the feces and sometimes in the urine of infected people. You can contract the infection if you eat food handled by someone with typhoid fever who hasn't washed carefully after using the bathroom. You can also become infected by drinking water contaminated with the bacteria.

Typhoid carriers
Even after treatment with antibiotics, a small number of people who recover from typhoid fever continue to harbor the bacteria in their intestinal tract or gallbladder, often for years. These people, called chronic carriers, shed the bacteria in their feces and are capable of infecting others, although they no longer have signs or symptoms of the disease themselves.

References
  1. Hohmann EL. Epidemiology, microbiology, clinical manifestations, and diagnosis of typhoid fever. http://www.uptodate.com/home/index.html. Accessed March 8, 2010.
  2. Hohmann EL. Pathogenesis of typhoid fever. http://www.uptodate.com/home/index.html. Accessed March 8, 2010.
  3. Mintz E. The pre-travel consultation: Travel-related vaccine-preventable diseases: Typhoid and paratyphoid fever. In: Brunette GW, et al. CDC Health Information for International Travel 2010. Atlanta, Ga.: U.S. Department of Health and Human Services, Public Health Service; 2009. http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/typhoid-paratyphoid-fever.aspx. Accessed March 9, 2010.
  4. Typhoid fever. Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/dbmd/diseaseinfo/typhoidfever_g.htm. Accessed March 9, 2010.
  5. Levine MM. Typhoid fever. In: Brachman PS, et al. Bacterial infections of humans: Epidemiology and control. 4th ed. New York, N.Y.: Springer; 2009:913.
  6. Bhutta ZA. Current concepts in the diagnosis and treatment of typhoid fever. British Medical Journal. 2006;333:78.
  7. Kaye KS, et al. Salmonella infections (including typhoid fever). In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/187350346-3/0/1492/1157.html?tocnode=54626101&fromURL=1157.html#4-u1.0-B978-1-4160-2805-5..50334-7_14301. Accessed March 9, 2010.
  8. Hohmann EL. Treatment and prevention of typhoid fever. http://www.uptodate.com/home/index.html. Accessed March 8, 2010.
DS00538 April 9, 2010

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