Typhoid Fever

Abstract

Typhoid fever continues to be a serious public health problem, with approximately 22. million cases and more than 200. 000 deaths globally. The disease is most often acquired by ingestion of food or water contaminated by the feces and less frequently by urine or vomitus of patients and carriers. Prolonged low-grade fever, headache, dry cough, alterations of bowel habits, coated tongue, and rose spots are the typical clinical features. Definitive diagnosis requires the isolation of Salmonella enterica serovar Typhi. Supportive serological tests are also used. First-choice antibiotic treatment includes fluoroquinolones or third-generation cephalosporins and reduces the mortality rate from 20% to 1%. A major problem is the emergence of antimicrobial resistance involving both Salmonella typhi and Salmonella paratyphi strains. Safe water, personal hygiene, and appropriate sanitation are the key preventive strategies. Vaccination is an additional tool for travelers and children living in endemic areas.