Most typhoid cases from traveling abroad
DEAR DOCTOR: How common — and dangerous — is typhoid fever? I read that a day-care center was shut down because a student there was sick with it. I thought typhoid was a thing of the past.
DEAR READER: Of the 5,700 cases of typhoid fever reported each year in the United States, the majority — about 75 percent, according to the federal Centers for Disease Control and Prevention — are contracted while traveling abroad. That turned out to be the case with the story you’re referring to. The day-care facility, located in Quincy, Massachusetts, was shut down after a child was diagnosed with the disease. People who had contact with the sick child underwent testing, and no other cases of the disease were found. The child who became ill received treatment and recovered.
Typhoid fever is a life-threatening illness caused by Salmonella typhi, a type of bacterium. It’s contracted by an estimated 21 million people worldwide each year and kills more than 220,000 of them. Symptoms include nausea, abdominal cramps, fatigue, headache, vomiting, loss of appetite and a dangerously high fever. These are similar to symptoms of the flu, which can sometimes delay an accurate diagnosis in areas where typhoid is not common. What distinguishes the illness, however, is the severity of these symptoms and the length of time for which they persist.
A diagnosis of typhoid fever is suspected when a patient has recently traveled internationally to an area where the disease is common. The diagnosis is confirmed via a sample of stool, urine, blood or bone marrow. The sample is placed in a special medium that allows the bacterium to flourish. The resulting culture is then visualized under a microscope to see whether the bacterium responsible for typhoid is indeed present. A typhoid fever diagnosis may also be confirmed with a test that detects the antibodies the immune system sends out in response to the typhoid bacterium, or a test that identifies typhoid DNA in the blood. The sole treatment for typhoid fever is antibiotics.