Typhoid Fever

Cause: Bacterium Salmonella Typhi.

Illness and treatment: Symptoms include fever, headache, rash, constipation or diarrhea, and lymph node swelling. Severity ranges from mild febrile illness to severe disease with multiple complications. Treatment is with antibiotics.

Sources: Humans are the reservoir and transmit through fecal contamination of food, water or milk, or directly person-to-person.

Additional risks: There can be a prolonged intestinal carrier state, sometimes due to gallbladder infection; re-culture patients after antibiotic treatment to confirm clearance of the infection.

Prevention: If traveling to risk areas, consult with a travel clinic or the CDC Travelers' Health website for recommendations about vaccination and other measures.

Recent Washington trends: Cases occur mainly after international travel, most commonly to Asia. Case counts are variable, ranging from 5 to 22 reports each year.

Purpose of Reporting and Surveillance

To determine if there is a source of infection of public health concern (e.g., a food handler or commercially distributed food product) and to stop transmission from such a source
To assess the risk of the case transmitting infection to others, and to prevent such transmission
To identify other undiagnosed cases

Legal Reporting Requirements

Health care providers and Health care facilities: notifiable to local health jurisdiction within 24 hours
Laboratories: Salmonella species including S. Typhi notifiable to local health jurisdiction within 24 hours; submission required – isolate or if no isolate specimen associated with a positive result, within 2 business days
Local health jurisdiction: notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE) within 7 days of case investigation completion or summary information required within 21 days