Typhoid fever is a bacterial infection that can spread throughout the body, affecting many

organs. Without prompt treatment, it can cause serious complications and can be fatal.

Typhoid fever is caused by Salmonella typhi bacteria. Typhoid fever is rare in

developed countries. It is still a serious health threat in the developing world,
especially for children.

Contaminated food and water or close contact with an infected person cause typhoid
fever. Signs and symptoms usually include:

 High fever

 Headache

 Stomach pain

 Constipation or diarrhea

Most people who have typhoid fever feel better a few days after they start antibiotic
treatment, but a small number of them may die of complications. Vaccines against
typhoid fever are only partially effective. Vaccines usually are reserved for those who
may be exposed to the disease or who are traveling to areas where typhoid fever is
common.

Symptoms

Signs and symptoms are likely to develop gradually — often appearing one to three
weeks after exposure to the disease.

Early illness

Signs and symptoms include:

 Fever that starts low and increases daily, possibly reaching as high as 104.9 F
(40.5 C)

 Headache

 Weakness and fatigue

 Muscle aches

 Sweating

 Dry cough
  Loss of appetite and weight loss

 Stomach pain

 Diarrhea or constipation

 Rash

 Extremely swollen stomach

Later illness

Without treatment, you may:

 Become delirious

 Lie motionless and exhausted with your eyes half-closed in what's known as the
typhoid state

Life-threatening complications often develop at this time.

In some people, signs and symptoms may return up to two weeks after the fever has
subsided.

When to see a doctor

See a doctor immediately if you think you might have typhoid fever. If you live in the
United States and become sick while traveling in a foreign country, call the U.S.
Consulate for a list of doctors.

If you have signs and symptoms after you return home, consider seeing a doctor
who focuses on international travel medicine or infectious diseases. A doctor who is
familiar with these areas may be able to recognize and treat your illness more
quickly.

Causes

Typhoid fever is caused by dangerous bacteria called Salmonella typhi. Salmonella

typhi is related to the bacteria that cause salmonellosis, another serious intestinal
infection, but they aren't the same.

Fecal-oral transmission route

Most people in developed countries pick up typhoid bacteria while they're traveling.
Once they have been infected, they can spread it to others through the fecal-oral
route.

This means that Salmonella typhi is passed in the feces and sometimes in the urine
of infected people. If you eat food that has been handled by someone who has
typhoid fever and who hasn't washed carefully after using the toilet, you can become
infected.

In developing countries, where typhoid fever is established, most people become

infected by drinking contaminated water. The bacteria may also spread through
contaminated food and through direct contact with someone who is infected.

Typhoid carriers

Even after antibiotic treatment, a small number of people who recover from typhoid
fever continue to harbor the bacteria. These people, known as chronic carriers, no
longer have signs or symptoms of the disease themselves. However, they still shed
the bacteria in their feces and are capable of infecting others.

Complications
Intestinal bleeding or holes

Intestinal bleeding or holes in the intestine are the most serious complications of
typhoid fever. They usually develop in the third week of illness. In this condition, the
small intestine or large bowel develops a hole. Contents from the intestine leak into
the stomach and can cause severe stomach pain, nausea, vomiting and bloodstream
infection (sepsis). This life-threatening complication requires immediate medical
care.

Other, less common complications

Other possible complications include:

 Inflammation of the heart muscle (myocarditis)

 Inflammation of the lining of the heart and valves (endocarditis)

 Infection of major blood vessels (mycotic aneurysm)

  Pneumonia

 Inflammation of the pancreas (pancreatitis)

 Kidney or bladder infections

 Infection and inflammation of the membranes and fluid surrounding your brain
and spinal cord (meningitis)

 Psychiatric problems, such as delirium, hallucinations and paranoid psychosis

With quick treatment, nearly all people in industrialized nations recover from typhoid
fever. Without treatment, some people may not survive complications of the disease.

Prevention

Safe drinking water, improved sanitation and adequate medical care can help
prevent and control typhoid fever. Unfortunately, in many developing nations, these
may be difficult to achieve. For this reason, some experts believe that vaccines are
the best way to control typhoid fever.

A vaccine is recommended if you live in or are traveling to areas where the risk of
getting typhoid fever is high.

Vaccines

Two vaccines are available.

 One is given as a single shot at least one week before travel.

 One is given orally in four capsules, with one capsule to be taken every other
day.

Neither vaccine is 100% effective. Both require repeat immunizations because their
effectiveness wears off over time.

Because the vaccine won't provide complete protection, follow these guidelines
when traveling to high-risk areas:

 Wash your hands. Frequent hand-washing in hot, soapy water is the best way
to control infection. Wash before eating or preparing food and after using the
toilet. Carry an alcohol-based hand sanitizer for times when water isn't
available.
  Avoid drinking untreated water. Contaminated drinking water is a particular
problem in areas where typhoid fever is endemic. For that reason, drink only
bottled water or canned or bottled carbonated beverages, wine and beer.
Carbonated bottled water is safer than non-carbonated bottled water.

Ask for drinks without ice. Use bottled water to brush your teeth, and try not to
swallow water in the shower.

 Avoid raw fruits and vegetables. Because raw produce may have been
washed in contaminated water, avoid fruits and vegetables that you can't peel,
especially lettuce. To be absolutely safe, you may want to avoid raw foods
entirely.

 Choose hot foods. Avoid food that's stored or served at room temperature.
Steaming hot foods are best. And although there's no guarantee that meals
served at the finest restaurants are safe, it's best to avoid food from street
vendors — it's more likely to be infected.

 Know where the doctors are. Find out in advance about medical care in the
areas you'll visit, and carry a list of the names, addresses and phone numbers
of recommended doctors.

A disease causative agent is substance that causes disease. Examples include biological
pathogens (such as a virus, bacteria, parasites, and fungus), toxins, tobacco, radiation, and
asbestos.

Infectious diseases are disorders caused by organisms — such as bacteria, viruses,

fungi or parasites. Many organisms live in and on our bodies. They're normally
harmless or even helpful. But under certain conditions, some organisms may cause
disease.

Some infectious diseases can be passed from person to person. Some are
transmitted by insects or other animals. And you may get others by consuming
contaminated food or water or being exposed to organisms in the environment.

Signs and symptoms vary depending on the organism causing the infection, but
often include fever and fatigue. Mild infections may respond to rest and home
remedies, while some life-threatening infections may need hospitalization.
Many infectious diseases, such as measles and chickenpox, can be prevented by
vaccines. Frequent and thorough hand-washing also helps protect you from most
infectious diseases.

Symptoms

Each infectious disease has its own specific signs and symptoms. General signs and
symptoms common to a number of infectious diseases include:

 Fever

 Diarrhea

 Fatigue

 Muscle aches

 Coughing

When to see a doctor

Seek medical attention if you:

 Have been bitten by an animal

 Are having trouble breathing

 Have been coughing for more than a week

 Have severe headache with fever

 Experience a rash or swelling

 Have unexplained or prolonged fever

 Have sudden vision problems

Causes

Infectious diseases can be caused by:

 Bacteria. These one-cell organisms are responsible for illnesses such as strep
throat, urinary tract infections and tuberculosis.

 Viruses. Even smaller than bacteria, viruses cause a multitude of diseases

ranging from the common cold to AIDS.
  Fungi. Many skin diseases, such as ringworm and athlete's foot, are caused by
fungi. Other types of fungi can infect your lungs or nervous system.

 Parasites. Malaria is caused by a tiny parasite that is transmitted by a mosquito

bite. Other parasites may be transmitted to humans from animal feces.

Direct contact

An easy way to catch most infectious diseases is by coming in contact with a person
or an animal with the infection. Infectious diseases can be spread through direct
contact such as:

 Person to person. Infectious diseases commonly spread through the direct

transfer of bacteria, viruses or other germs from one person to another. This
can happen when an individual with the bacterium or virus touches, kisses, or
coughs or sneezes on someone who isn't infected.

These germs can also spread through the exchange of body fluids from sexual
contact. The person who passes the germ may have no symptoms of the
disease, but may simply be a carrier.

 Animal to person. Being bitten or scratched by an infected animal — even a

pet — can make you sick and, in extreme circumstances, can be fatal. Handling
animal waste can be hazardous, too. For example, you can get a toxoplasmosis
infection by scooping your cat's litter box.

 Mother to unborn child. A pregnant woman may pass germs that cause
infectious diseases to her unborn baby. Some germs can pass through the
placenta or through breast milk. Germs in the vagina can also be transmitted to
the baby during birth.

Indirect contact

Disease-causing organisms also can be passed by indirect contact. Many germs can
linger on an inanimate object, such as a tabletop, doorknob or faucet handle.

When you touch a doorknob handled by someone ill with the flu or a cold, for
example, you can pick up the germs he or she left behind. If you then touch your
eyes, mouth or nose before washing your hands, you may become infected.

Insect bites
Some germs rely on insect carriers — such as mosquitoes, fleas, lice or ticks — to
move from host to host. These carriers are known as vectors. Mosquitoes can carry
the malaria parasite or West Nile virus. Deer ticks may carry the bacterium that
causes Lyme disease.

Food contamination

Disease-causing germs can also infect you through contaminated food and water.
This mechanism of transmission allows germs to be spread to many people through
a single source. Escherichia coli (E. coli), for example, is a bacterium present in or
on certain foods — such as undercooked hamburger or unpasteurized fruit juice.

Risk factors

While anyone can catch infectious diseases, you may be more likely to get sick if
your immune system isn't working properly. This may occur if:

 You're taking steroids or other medications that suppress your immune system,
such as anti-rejection drugs for a transplanted organ

 You have HIV or AIDS

 You have certain types of cancer or other disorders that affect your immune
system

In addition, certain other medical conditions may predispose you to infection,

including implanted medical devices, malnutrition and extremes of age, among
others.

Complications

Most infectious diseases have only minor complications. But some infections — such
as pneumonia, AIDS and meningitis — can become life-threatening. A few types of
infections have been linked to a long-term increased risk of cancer:

 Human papillomavirus is linked to cervical cancer

 Helicobacter pylori is linked to stomach cancer and peptic ulcers

 Hepatitis B and C have been linked to liver cancer

In addition, some infectious diseases may become silent, only to appear again in the
future — sometimes even decades later. For example, someone who's had
chickenpox may develop shingles much later in life.

Prevention

Follow these tips to decrease the risk of infection:

 Wash your hands. This is especially important before and after preparing food,
before eating, and after using the toilet. And try not to touch your eyes, nose or
mouth with your hands, as that's a common way germs enter the body.

 Get vaccinated. Vaccination can drastically reduce your chances of contracting

many diseases. Make sure to keep up to date on your recommended
vaccinations, as well as your children's.

 Stay home when ill. Don't go to work if you are vomiting, have diarrhea or
have a fever. Don't send your child to school if he or she has these signs,
either.

 Prepare food safely. Keep counters and other kitchen surfaces clean when
preparing meals. Cook foods to the proper temperature, using a food
thermometer to check for doneness. For ground meats, that means at least 160
F (71 C); for poultry, 165 F (74 C); and for most other meats, at least 145 F (63
C).

Also promptly refrigerate leftovers — don't let cooked foods remain at room
temperature for long periods of time.

 Practice safe sex. Always use condoms if you or your partner has a history of
sexually transmitted infections or high-risk behavior.

 Don't share personal items. Use your own toothbrush, comb and razor. Avoid
sharing drinking glasses or dining utensils.

 Travel wisely. If you're traveling out of the country, talk to your doctor about
any special vaccinations — such as yellow fever, cholera, hepatitis A or B, or
typhoid fever — you may need.