S is for Salmonella Typhi
Salmonella typhi is the causative agent of typhoid fever. Typhoid is carried by people in their blood and intestinal tract. It is spread through fecal contamination. Therefore, maintaining good hygiene and avoiding contaminated food and water is essential in preventing new and spreading disease.
Typhoid is most common in the developing world with about 21.5 million cases each year worldwide. The United States has an estimated 5,700 cases, with up to 75% of those diseases obtained while traveling internationally. There are two types of vaccines available in the USA, an injection that lasts for two years and a series of oral tablets that last for 5 years before needing to be boostered. Neither vaccine is 100% protective, so maintaining good hygiene, only drinking bottled or boiled water (rolling boil for at least 1 minute) and not tap water is necessary. Also, being vigilant about food is imperative. Eating only fully cooked foods, avoiding raw fruits and vegetables that you cannot peel yourself, and avoid street food and ice cubes will go a long way to protect yourself.
The symptoms of Typhoid fever are progressive. If you suspect that you may have developed Typhoid, it is recommended to seek medical care as quickly as possible. The most common signs are fever (103-104 F/39.4-40 C), weakness, fatigue, abdominal pain, diarrhea or constipation, and rash. These are seen the first week with progression of the disease through the second and third weeks when complications can result in death. Treatment is generally with antibiotics – ciprofloxacin is the most common and is often given to be used if diarrhea develops while traveling. Treatment of dehydration and other symptoms are also important.
Mary Mallon, also known as “Typhoid Mary.” She was the first known asymptomatic carrier in the USA. She was born in Ireland and immigrated to the United States where she began working as a cook. Over the years, there were many typhoid outbreaks. A researcher was able to trace the infections to Mary, but she would not agree to any testing to connect her to the outbreaks. Eventually, she was arrested and samples were taken proving that she was an asymptomatic carrier. She was placed in quarantine for 3 years and was instructed to never work with food since she refused to wash her hands and maintaining proper hygiene when cooking. She was given a job as a laundress, but left, changed her name to Molly Brown, and began working as a cook. Everywhere she worked, more outbreaks followed, but she would move between jobs regularly. After an outbreak at the New York’s Sloane Hospital for Women in which infected 25 individuals and killed 2, it was found that a woman matching Mary’s description had disappeared from the kitchen, they were on her trail again. She was then found working in an estate kitchen on Long Island. She was placed back into quarantine until her death in 1938 from pneumonia.