acute, generalized infection caused by Salmonella typhi.
The main sources of infection are contaminated water or milk and, especially in urban communities, food handlers who are carriers. The symptoms of typhoid appear 10 to 14 days after infection; they include high fever, rose-colored spots on the abdomen and chest, diarrhea or constipation, and enlargement of the spleen. Complications, especially in untreated patients, may be numerous, affecting practically every body system, and they account for the mortality rate of 7% to 14%. Perforation of the intestine with hemorrhage is not uncommon. Chloramphenicol is the most effective drug in combating typhoid, and in very toxic patients a cortisone derivative may be helpful. Skilled nursing care is still of the utmost importance, as is a high caloric diet to prevent wasting of the body. Vaccination against typhoid is a valuable preventive measure, especially for persons in military service and for those who travel to poorly sanitized regions.