The number of sporadic cases of typhoid fever has remained relatively constant in the industrialized world, and with the advent of proper sanitary facilities, has been virtually eliminated in many areas. Most cases in developed countries are imported from endemic countries. Strains resistant to chloramphenicol and other recommended antibiotics have become prevalent in several areas of the world. Multidrug resistant strains have been reported from Asia, the Middle East and Latin America. Transmission Typhoid fever is transmitted by food and water contaminated by the faeces and urine of patients and carriers.
Polluted water is the most common source of typhoid.
In addition, shellfish taken from sewage contaminated beds, vegetables fertilized by nightsoil and eaten raw, contaminated milk and milk products have been shown as a source of infection. Routine use of vaccine is not recommended. Food and water samples should be taken from suspected sources of the outbreak for laboratory testing. It is also recommended to organize temporary water purification and sanitation facilities until longer term measures can be implemented. Disaster implications With disruption of the usual water supply and sewage disposal, and of the elimination or reduction of controls on food and water, transmission of typhoid fever may occur if there are active cases or carriers.