Overview
| Generalities | |
| Agent | Bacteria: salmonella enterica subsp. Enteric serovar typhi or paratyphi A or B |
| Incubation | 31-60 days (8-14 days) |
| Period of communicability | As long as the bacteria is in feces. The disease is communicable for as long as the infected person excretes S.typhi in their excreta, usually after the 1st week of illness through convalescence. Approximately 10% of untreated cases will excrete S. typhi for 3 months and between 2-5% of all cases become chronic carriers. |
| Reservoir | Humans |
| Modes of transmission | Consumption of contaminated food: shellfish, fruits /vegetables, milk and milk products by food handlers. Food can be contaminated by flies. Consumption of contaminated water |
| Clinical | a)Systemic bacteria infection. -Mild illness: low grade fever, malaise and dry cough,disturbances of bowel function(constipation in adults, diarrhea in children), headache, malaise and anorexia. Bronchitic cough is common in the early stage of the illness. During the period of fever, up to 25% of patients show a rash or rose spots, on the chest, abdomen and back. -Severe illness: abdominal discomfort, altered mental status and multiple complications(intestinal hemorrhage or peritonitis due to intestinal perforation) b) Carrier state: 1-5% of patients, depending on age, become chronic carriers harboring S.typhi in the gallbladder |
| Worldwide | WHO estimates that 21 million typhoid cases and 216 000–600 000 typhoid-related deaths occur annually worldwide |
| Lebanon | Endemic, the annual incidence is 8-21 reported cases per 100,000 |
| Control objective | Control |
| National figures (salmonella non typhi to exclude) | |
| Figure 1: Reported Typhoid fever incidence rate (per 100000), Lebanon, 1997-2013 (Source: MOPH) | |
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| International figures(Source: G C. Buckle, C L Fisher Walker, R E Black. Typhoid fever and paratyphoid fever: systematic review to estimate global morbidity and mortality for 2010. Journal of Global health, June 2012, vol 2 no 1) | |
| Table 1: Incidence of Typhoid fever worldwide (Source: WHO) | |
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