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History of typhoid fever
From Wikipedia, the free encyclopedia
In 2000, typhoid fever caused an estimated 21.7 million illnesses and 217,000 deaths.[1] It occurs most often in children and young adults between 5 and 19 years old.[2] In 2013, it resulted in about 161,000 deaths – down from 181,000 in 1990.[3] Infants, children, and adolescents in south-central and Southeast Asia experience the greatest burden of illness.[4] Outbreaks of typhoid fever are also frequently reported from sub-Saharan Africa and countries in Southeast Asia.[5][6][7] In the United States, about 400 cases occur each year, and 75% of these are acquired while traveling internationally.[8][9]
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Historically, before the antibiotic era, the case fatality rate of typhoid fever was 10–20%. Today, with prompt treatment, it is less than 1%.[10] However, about 3–5% of individuals who are infected develop a chronic infection in the gall bladder.[11] Since S. e. subsp. enterica is human-restricted, these chronic carriers become the crucial reservoir, which can persist for decades for further spread of the disease, further complicating the identification and treatment of the disease.[12] Lately, the study of S. e. subsp. enterica associated with a large outbreak and a carrier at the genome level provides new insights into the pathogenesis of the pathogen.[13][14]
In industrialized nations, water sanitation and food handling improvements have reduced the number of cases.[15] Developing nations, such as those found in parts of Asia and Africa, have the highest rates of typhoid fever. These areas have a lack of access to clean water, proper sanitation systems, and proper health-care facilities. For these areas, such access to basic public-health needs is not in the near future.[16]