Typhoid And Paratyphoid Infection

Typhoid and Paratyphoid Fever

Typhoid and paratyphoid fevers have been described in detail by Benenson (12). Typhoid fever is a systemic disease characterized by onset of sustained fever, headache, malaise, anorexia, etc. It is caused by the bacterium Salmonella typhi, which can be isolated from the blood, feces, and urine of patients. The usual fatality rate of 10% can be reduced to < 1% with prompt antibiotic treatment. Paratyphoid fever presents a similar clinical picture but tends to be milder and the case fatality rate is much lower. The infectious agents are Salmonella paratyphi A, B, and C. Paratyphi B is the most common whereas C is extremely rate. Both are transmitted by food and water contaminated by the feces and urine of patients and carriers.

With the development of sanitary facilities, typhoid and paratyphoid fever have been virtually eliminated from Europe and the Western world, but are still endemic in many parts of the world such as Asia, the Middle East, and Latin America. In 1950 2484 cases of typhoid fever were reported in the United States, but for several years it has been fairly constant, with fewer than 500 cases (12). In England and Wales the number of cases have been relatively constant since 1982 (Table 2), and for typhoid fever (as compared with paratyphoid fever) have been mainly contracted abroad. However, outbreaks such as the one in Aberdeen in 1964 do occur. In May 1964, 507 people were infected by S. typhi, phage type 34 (13), a phage type strain common in South America and Spain, but almost unknown in the United Kingdom. This was traced to contaminated sliced corned beef originating in South America. This outbreak left a legacy of six chronic carriers, in spite of antibiotic treatment (14).

Typhoid Carriers

A chronic faecal typhoid carrier is defined as one whose feces contain typhoid bacilli, but who does not give a history of typhoid fever within the preceding year (15).

Table 2

Statutory Notifications of Typhoid and Paratyphoid Fever in England and Wales 1982-1987 Communicable Disease Surveillance Centre, Public Health Laboratory, Colindale, London, UK"

Typhoid fever contracted Paratyphoid fever contracted

Table 2

Statutory Notifications of Typhoid and Paratyphoid Fever in England and Wales 1982-1987 Communicable Disease Surveillance Centre, Public Health Laboratory, Colindale, London, UK"

Typhoid fever contracted Paratyphoid fever contracted

Year

Abroad

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