Let's talk infectious diseases, the reason for vaccines: ᵀʸᵖʰᵒⁱᵈ ᶠᵉᵛᵉʳ

Typhoid fever is caused by Salmonella typhi bacteria. Salmonella typhi is related to the bacteria that cause salmonellosis, another serious intestinal infection, but they aren't the same.

Typhoid fever is a serious worldwide threat and affects about 27 million or more people each year. It is rare in developed countries and still a serious health threat in the developing world, especially for children.

Contaminated food and water or close contact with an infected person cause typhoid fever. Salmonella typhi is passed in the feces and sometimes in the urine of infected people. If you eat food that has been handled by someone who has typhoid fever and who hasn't washed carefully after using the toilet, you can become infected. In developing countries, where typhoid fever is established, most people become infected by drinking contaminated water. The bacteria may also spread through contaminated food and through direct contact with someone who is infected.

Signs and symptoms are likely to develop gradually — often appearing one to three weeks after exposure to the disease. Early illness signs and symptoms include:

▪️Fever that starts low and increases daily, possibly reaching as high as 104.9 F

▪️Headache

▪️Weakness and fatigue

▪️Muscle aches

▪️Sweating

▪️Dry cough

▪️Loss of appetite and weight loss

▪️Stomach pain

▪️Diarrhea or constipation

▪️Rash

▪️Extremely swollen stomach

Without treatment, you may:

▪️Become delirious

▪️Lie motionless and exhausted with your eyes half-closed in what's known as the typhoid state

▪️Life-threatening complications often develop at this time.

Most people who have typhoid fever feel better a few days after they start antibiotic treatment, but a small number of them may die of complications. Vaccines against typhoid fever are only partially effective. Vaccines usually are reserved for those who may be exposed to the disease or who are traveling to areas where typhoid fever is common.

Henry Prince of Wales, the oldest son of King James I, died at age 18 in 1612 after a “short illness” which was not identified or described other than as a fever. In 1882, Norman Moore, MD, based on his studies of the autopsy on the prince as well as detailed descriptions of the illness, alleged that the prince had died of typhoid fever. If he was correct (today it is generally assumed that he was) this would have been the earliest English case of typhoid fever on record.

Fast forward to 1896 when finally there was momentum on typhoid treatment. Richard Pfeiffer and Wilhelm Kolle demonstrated that inoculation with killed typhoid bacteria resulted in human immunity against typhoid fever. Almroth E. Wright published a paper a few months later in 1897, in which he described a similar finding.

U.S. Army physician Frederick F. Russell developed the first U.S. typhoid fever vaccine in 1909. In 1914 Almroth E. Wright developed an effective typhoid vaccine as well.

Early forms of the typhoid vaccine were used by the British Army in 1899 during the Second Boer War in southern Africa. Nearly 15,000 soldiers were immunized; among these men, there were approximately 11 cases of typhoid fever per 1,000 soldiers. In contrast, unimmunized soldiers saw approximately 31 cases of typhoid fever per 1,000 men.

Typhoid vaccination would become an important part of military life. Mandatory typhoid vaccination for a division of 15,000 men in the United States Army began in 1911, with the mandate expanded to include all soldiers only a few months later.

By 1914, typhoid vaccination had moved beyond military forces in the United States and into use for the general public, specifically for those traveling.

Two typhoid vaccines are licensed for use in the United States. The Ty21a is a live, attenuated vaccine given in oral capsule form. Vi capsular polysaccharide (ViCPS) is an injected subunit vaccine. These are typically reserved for people traveling to areas where typhoid fever is common or for people who may come into direct contact with the disease.

We can't talk about Typhoid without talking about Mary Mallon, or Typhoid Mary as she is better known. Mary Mallon was an asymptomatic carrier of Typhoid.

Mallon, an Irish immigrant who worked as a cook for wealthy New York families, first gained the attention of public health officials in 1906. A Long Island family for whom Mallon had worked as a cook had fallen ill with typhoid fever. Though Mallon was no longer with the family, officials trying to locate her discovered that other families she’d worked for had also developed typhoid fever. In one outbreak at a household of nine in Dark Harbor, Maine, in 1902, Mallon and Mr. Coleman Drayton, head of the household, were the only two not to fall ill (Drayton had contracted typhoid fever years before).

In 1907, Mallon was detained by the New York City Department of Health for three years, first at a hospital for contagious diseases in Manhattan, and then at Riverside Hospital on North Brother’s Island in the East River to be kept in isolation. She was released in 1910 under the conditions that she would no longer work as a cook and would take steps to prevent spreading typhoid.

In 1915, however, Mallon was caught once again working as a cook (this time under the assumed name Mary Brown) after infecting 25 people with typhoid, one of whom died. Mallon was eventually sent back to North Brother Island and remained there for the next 23 years until her death in 1938.

At the time of her death in 1938, she was officially blamed for 10 outbreaks totaling 51 cases of typhoid fever, and three deaths from the disease.

{You can find all the sources I used by clicking here.}