Almroth Edward Wright developed the first effective typhoid vaccine.
“Typhoid fever is a bacterial infection that can spread throughout the body, affecting many organs. Without prompt treatment, it can cause serious complications and can be fatal” (“Typhoid Fever,” National Health Services UK).
It is spread by eating or drinking food or water contaminated with the feces of an infected person.
Onset symptoms are fever, malaise, headache, cough, bloody nose, weakness, general aches and pains, and abdominal pain. In the second week, symptoms grow more severe, including increase in weakness and fatigue, rise in fever, delirium (thus the nickname “nervous fever”), rattling in the chest (rhonchi), enlarged and tender spleen and liver, distended and painful abdomen, diarrhea or constipation. Some develop a rose-colored skin rash.
Beginning in the third week, complications can lead to death in about 20% of the cases. These include intestinal hemorrhage, intestinal perforation, peritonitis, septicemia, pneumonia, acute bronchitis, neuropsychiatric symptoms (“muttering delirium”), dehydration, delirium, and risk of bleeding.
Without treatment, symptoms can last weeks or even months.
About 3%-5% of victims are left with a chronic gall bladder infection.
A vaccine for typhoid was developed in 1897 by English bacteriologist Almroth Wright. The vaccine was used sparingly by the British military in the Boer War (1899-1902) and was made compulsory in World War I (1914-1918). “For the first time, their casualties due to combat exceeded those from disease” (“Medical Lessons from World War I,” Minneapolis Post, Nov. 11, 2014). It was estimated to have saved up to half a million lives. The British military fatality rate from typhoid fell from 12.6 per 1,000 in the Boer War to 0.14 per 1,000 in World War I. In 1911, the U.S. Army became the first army to be fully immunized by vaccination.
Typhoid vaccinations are recommended for those traveling in high risk areas, which are the Indian subcontinent, Africa, South and Southeast Asia, and South America.
In 2015, 12.5 million cases were reported, resulting in about 149,000 deaths.
Typhoid can be treated with antibiotics. Formerly, ciprofloxicin, ampicillin, and streptomycin were among the first-line treatments, but a multi-drug resistant form of typhoid is a growing problem, particularly in the Indian subcontinent and Southeast Asia. In areas of multidrug-resistant typhoid, first-line drugs are ceftriaxone (by injection) and azithromycin (by mouth).
Treatment reduces the fatality rate to about 1%.
Typhoid Mary. Between 1900 and 1907, there were small outbreaks of typhoid in several households in New York City. The infections were traced to Mary Mallon (1869-1938), an Irish domestic cook who was a non-symptomatic carrier and had been employed in each of the homes. She was isolated in Riverside Hospital until 1910, when she was released after promising not to take employment that involved the handling of food. In 1914, typhoid broke out in two hospitals in New Jersey and Manhattan, and it was discovered that Mary had worked at both places. She was re-incarcerated in Riverside Hospital and remained there until her death 23 years later. It was said that she was directly responsible for 51 cases of typhoid and three deaths, and many more indirectly. She was called “Typhoid Mary” by the New York American newspaper in June 1909. Today that term refers to “a person or object that brings widespread death and destruction.”
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