Typhoid fever

Associated with high fever, malaise, influenza symptoms, abdominal pain, relative bradycardia, constipation or diarrhea.

Fever typically, high, prolonged with spikes in the morning, not accompanied by chills, and associated with bradycardia.

Caused by Salmonella enterica, serotype Typhi (S. Typhi) results in approximately 216,000 to 600,000 deaths annually mainly in developing countries.

It is responsible for more than 9 million infections more than 110,000 deaths globally each year.

It is the highest disease burden among school-age children and preschool children.


Transmission  by fecal-oral route.

Estimated 11-21,000,000 cases of febrile illness and 117,000-161,000 deaths are attributed to the disease each year.

Rare in the U.S., with approximately 300 cases per year.

Usually in the differential diagnoses of travelers returning from malarious areas.

Decline in incidence and mortality related to municipal water and sewage treatment systems.

Majority of cases in the U.S. associated with foreign travel.

Up to 10% of patients have bloody diarrhea related to erosion of blood vessels adjacent to necrotic Peyer’s patches.y

Vi polysaccharide vaccine is given as a single dose, and is licensed for persons 2 years of age or older.

In a study of 37,673 children 2 years or older received a dose of either Vi vaccine or inactivated hepatitis A vaccine and followed for 2 years: resulted in a level of protective effectiveness of the Vi vaccine of 61% and among unvaccinated members (herd protection) of the Vi clusters of 44%(Dipika Sur).

Vaccine Vi provides protection for children under the age of 5 years with 80% protection.

TCV is immunogenic an pd effective in reducing S. Typhi bacteremia and children nine months-16 years of age.

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