American Medical Association Family Medical Guide - American Medical Association [657]
Typhoid Fever
Typhoid fever is an infectious disease spread under unsanitary conditions from person to person or through contaminated food or water. Some people carry typhoid-causing bacteria in their body after they have the disease (even without having symptoms) and can infect others. Typhoid fever is rare in the United States, although the disease occurs occasionally in rural areas. Nearly all cases can be traced to recent travel or residence in a developing country. If you are planning to travel to a developing country, talk to your doctor. Depending on the country, he or she will probably recommend that you have a vaccination against typhoid.
Symptoms
The symptoms of typhoid fever begin suddenly with headache, loss of appetite, and vomiting followed by a persistent fever of about 104°F, chills, increasing weakness, diarrhea (usually bloody), and, often, delirium. Early in the disease, you may have a pink rash on your abdomen (called rose spots), which then fades. In severe cases, a person can have extensive gastrointestinal bleeding or rupture of the intestines, which can be life-threatening.
Diagnosis and Treatment
If you have recently returned from a developing country and have symptoms of typhoid fever, see a doctor immediately. If he or she suspects you could have typhoid fever, you will be admitted to a hospital isolation unit. You may have a blood test to look for antityphoid antibodies (proteins the body produces to fight the bacteria) or to detect the bacterium itself. A doctor may also take a stool sample to look for the bacteria. If you have typhoid fever, your doctor will prescribe antibiotics, which you will need to take for about 7 to 14 days. It may be several more weeks before your digestive tract is free of infectious bacteria; during this time, you can still transmit the infection to others. To make sure that you are free of typhoid bacteria, your doctor will examine a sample of your stool each month for at least 3 months (longer if you are a food handler).
Yellow Fever
Yellow fever is a disease caused by a virus that damages the liver and kidneys. The virus is transmitted through Aedes mosquito bites and occurs in South America and Africa. As with many viral infections, there is no effective treatment for yellow fever. A person who has recovered from yellow fever is immune to it for life. A vaccine is available to prevent yellow fever in people who are traveling to countries where the disease may be prevalent. However, the vaccination is not recommended for children younger than 6 months, pregnant women, or people who are allergic to eggs or who have a weakened immune system.
Symptoms
The symptoms of yellow fever, which develop 3 to 6 days after the infecting mosquito bite, can be mild to severe. A mild case produces symptoms that resemble those of the flu (see page 649). Symptoms of more severe cases include fever, headache, abdominal pain and vomiting, bleeding from the gums, frequent nosebleeds, easy bruising, blood in stool or vomit, and yellowing of the skin and whites of the eyes (jaundice; see page 785). Other possible symptoms include confusion, kidney failure, and coma.
Diagnosis and Treatment
To diagnose yellow fever, a doctor will perform blood tests to check for antibodies (proteins the body produces to fight the virus) or for the virus itself.
There is no treatment for yellow fever.