History of typhoid fever explained

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]

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]

Ancient Greece and typhoid fever

In 430 BC, a plague killed one-third of the population of Athens, including their leader Pericles. Following this disaster, the balance of power shifted from Athens to Sparta, ending the Golden Age of Pericles that had marked Athenian dominance in the Greek ancient world. The ancient historian Thucydides also contracted the disease, but he recovered and wrote about the plague. His writings are the primary source of information on this outbreak, and modern academics and medical scientists consider typhoid fever the most likely cause. In 2006, a study detected DNA sequences similar to those of the bacterium responsible for typhoid fever in dental pulp extracted from a burial pit dated to the time of the outbreak.[17]

The cause of the plague has long been disputed and other scientists have disputed the findings, citing serious methodologic flaws in the dental pulp-derived DNA study.[18] The disease is most commonly transmitted through poor hygiene habits and public sanitation conditions; during the period in question related to Athens above, the whole population of Attica was besieged within the Long Walls and lived in tents.

16th and 17th centuries

A pair of epidemics struck the Mexican highlands in 1545 and 1576, causing an estimated 7 to 17 million deaths.[19] A study published in 2018 suggests that the cause was typhoid fever.[20] [21]

Some historians believe that the English colony of Jamestown, Virginia, died out from typhoid. Typhoid fever killed more than 6,000 settlers in the New World between 1607 and 1624.[22]

19th century

A long-held belief is that 9th US President William Henry Harrison died of pneumonia, but recent studies suggest he likely died from typhoid.

This disease may also have been a contributing factor in the death of 12th US President Zachary Taylor due to the unsanitary conditions in Washington, DC, in the mid-19th century.[23] [24]

During the American Civil War, 81,360 Union soldiers died of typhoid or dysentery, far more than died of battle wounds.[25] In the late 19th century, the typhoid fever mortality rate in Chicago averaged 65 per 100,000 people a year. The worst year was 1891, when the typhoid death rate was 174 per 100,000 people.[26]

During the Spanish–American War, American troops were exposed to typhoid fever in stateside training camps and overseas, largely due to inadequate sanitation systems. The Surgeon General of the Army, George Miller Sternberg, suggested that the War Department create a Typhoid Fever Board. Major Walter Reed, Edward O. Shakespeare, and Victor C. Vaughan were appointed August 18, 1898, with Reed being designated the president of the board. The Typhoid Board determined that during the war, more soldiers died from this disease than from yellow fever or from battle wounds. The board promoted sanitary measures including latrine policy, disinfection, camp relocation, and water sterilization, but by far the most successful antityphoid method was vaccination, which became compulsory in June 1911 for all federal troops.[27]

20th century

In 1902, local government board inspector H Timbrell Bulstrode, led an investigation when guests at mayoral banquets in Southampton and Winchester, England, became ill and four died, including the Dean of Winchester, after consuming oysters.[28] The infection was due to oysters sourced from Emsworth, where the oyster beds had been contaminated with raw sewage.[29] [30]

The most notorious carrier of typhoid fever, but by no means the most destructive, was Mary Mallon, also known as Typhoid Mary. In 1907, she became the first carrier in the United States to be identified and traced. She was a cook in New York, who was closely associated with 53 cases and three deaths.[31] Public-health authorities told Mary to give up working as a cook or have her gall bladder removed, as she had a chronic infection that kept her active as a carrier of the disease. Mary quit her job, but returned later under a false name. She was detained and quarantined after another typhoid outbreak. She died of pneumonia in 1938, after 26 years in quarantine.[32] [33]

A well-publicised outbreak occurred in Croydon, Surrey, now part of London, in 1937.[34] It resulted in 341 cases of typhoid (43 fatal),[35] [36] and it caused considerable local discontent.[37] [38] [39] While repair work was being performed on the primary well, the water supply was no longer being filtered and chlorinated. The infection was traced to one repair workman, who was (unwittingly) an active carrier of typhoid.[40]

A notable outbreak occurred in Aberdeen, Scotland, in 1964, due to contaminated tinned meat sold at the city's branch of the William Low chain of stores. There were three deaths connected with the outbreak,[41] and over 400 cases were diagnosed.[42]

21st century

In 2004–2005, an outbreak in the Democratic Republic of Congo resulted in more than 42,000 cases and 214 deaths. Since November 2016, Pakistan has had an outbreak of extensively drug-resistant (XDR) typhoid fever.[43]

In 2020 a meta-analysis of reports of drug resistant typhoid fever revealed that among all Typhi isolates, 9,056 (25.9%) of 34,996 were resistant to chloramphenicol, 13,481 (38.8%) of 34,783 to ampicillin, and 13,366 (37.9%) of 35,270 to trimethoprim–sulfamethoxazol.[44] Of isolates in the time periods 2005 –2009, 2010–2014, and 2015–2018; 2.1%, 4.1%, and 6.7% were resistant to azithromycin, indicating a steady increase in resistance to first-line treatment. Multi-drug resistant (MDR) typhoid remains prevalent in Asia, with resistance developing to an increasing number of antimicrobial classes such that extensively-drug resistant (XDR) Salmonella Typhi is now a major threat. MDR Salmonella Typhi is a growing problem in Africa.

Notes and References

  1. Crump JA, Mintz ED . Global trends in typhoid and paratyphoid Fever . Clinical Infectious Diseases . 50 . 2 . 241–246 . January 2010 . 20014951 . 2798017 . 10.1086/649541 .
  2. Web site: Typhoid Fever . World Health Organization . August 28, 2007 . dead . https://web.archive.org/web/20111102190825/http://www.who.int/vaccine_research/diseases/diarrhoeal/en/index7.html . November 2, 2011 .
  3. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013 . Lancet . 385 . 9963 . 117–171 . January 2015 . 25530442 . 4340604 . 10.1016/S0140-6736(14)61682-2 .
  4. Crump JA, Luby SP, Mintz ED . The global burden of typhoid fever . Bulletin of the World Health Organization . 82 . 5 . 346–353 . May 2004 . 15298225 . 2622843 .
  5. Muyembe-Tamfum JJ, Veyi J, Kaswa M, Lunguya O, Verhaegen J, Boelaert M . An outbreak of peritonitis caused by multidrug-resistant Salmonella Typhi in Kinshasa, Democratic Republic of Congo . Travel Medicine and Infectious Disease . 7 . 1 . 40–43 . January 2009 . 19174300 . 10.1016/j.tmaid.2008.12.006 .
  6. Baddam R, Kumar N, Thong KL, Ngoi ST, Teh CS, Yap KP, Chai LC, Avasthi TS, Ahmed N . 6 . Genetic fine structure of a Salmonella enterica serovar Typhi strain associated with the 2005 outbreak of typhoid fever in Kelantan, Malaysia . Journal of Bacteriology . 194 . 13 . 3565–3566 . July 2012 . 22689247 . 3434757 . 10.1128/jb.00581-12 .
  7. Yap KP, Teh CS, Baddam R, Chai LC, Kumar N, Avasthi TS, Ahmed N, Thong KL . 6 . Insights from the genome sequence of a Salmonella enterica serovar Typhi strain associated with a sporadic case of typhoid fever in Malaysia . Journal of Bacteriology . 194 . 18 . 5124–5125 . September 2012 . 22933756 . 3430317 . 10.1128/jb.01062-12 .
  8. Matano LM, Morris HG, Wood BM, Meredith TC, Walker S . Accelerating the discovery of antibacterial compounds using pathway-directed whole cell screening . Bioorganic & Medicinal Chemistry . 24 . 24 . 6307–6314 . December 2016 . 27594549 . 5180449 . 10.1016/j.bmc.2016.08.003 .
  9. Web site: Typhoid Fever Guide to Surveillance and Investigation . floridahealth.gov . Florida Department of Health . 5 July 2024 . December 23, 2013 . June 26, 2024 . https://web.archive.org/web/20240626100057/https://www.floridahealth.gov/diseases-and-conditions/disease-reporting-and-management/disease-reporting-and-surveillance/_documents/gsi-typhoid-fever.pdf . live .
  10. [David L. Heymann|Heymann, David L.]
  11. Levine MM, Black RE, Lanata C . Precise estimation of the numbers of chronic carriers of Salmonella typhi in Santiago, Chile, an endemic area . The Journal of Infectious Diseases . 146 . 6 . 724–726 . December 1982 . 7142746 . 10.1093/infdis/146.6.724 .
  12. Gonzalez-Escobedo G, Marshall JM, Gunn JS . Chronic and acute infection of the gall bladder by Salmonella Typhi: understanding the carrier state . Nature Reviews. Microbiology . 9 . 1 . 9–14 . January 2011 . 21113180 . 3255095 . 10.1038/nrmicro2490 .
  13. Yap KP, Gan HM, Teh CS, Baddam R, Chai LC, Kumar N, Tiruvayipati SA, Ahmed N, Thong KL . 6 . Genome sequence and comparative pathogenomics analysis of a Salmonella enterica Serovar Typhi strain associated with a typhoid carrier in Malaysia . Journal of Bacteriology . 194 . 21 . 5970–5971 . November 2012 . 23045488 . 3486090 . 10.1128/jb.01416-12 .
  14. Yap KP, Gan HM, Teh CS, Chai LC, Thong KL . Comparative genomics of closely related Salmonella enterica serovar Typhi strains reveals genome dynamics and the acquisition of novel pathogenic elements . BMC Genomics . 15 . 1 . 1007 . November 2014 . 25412680 . 4289253 . 10.1186/1471-2164-15-1007 . free .
  15. Crump JA, Sjölund-Karlsson M, Gordon MA, Parry CM . Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections . Clinical Microbiology Reviews . 28 . 4 . 901–937 . October 2015 . 26180063 . 4503790 . 10.1128/CMR.00002-15 .
  16. Khan MI, Pach A, Khan GM, Bajracharya D, Sahastrabuddhe S, Bhutta W, Tahir R, Soofi S, Thapa CB, Joshi N, Puri MK, Shrestha P, Upreti SR, Clemens JD, Bhutta Z, Ochiai RL . 6 . Typhoid vaccine introduction: An evidence-based pilot implementation project in Nepal and Pakistan . Vaccine . 33 . Suppl 3 . C62–C67 . June 2015 . 25937612 . 10.1016/j.vaccine.2015.03.087 .
  17. Papagrigorakis MJ, Yapijakis C, Synodinos PN, Baziotopoulou-Valavani E . DNA examination of ancient dental pulp incriminates typhoid fever as a probable cause of the Plague of Athens . International Journal of Infectious Diseases . 10 . 3 . 206–214 . May 2006 . 16412683 . 10.1016/j.ijid.2005.09.001 . free .
  18. Shapiro B, Rambaut A, Gilbert MT . No proof that typhoid caused the Plague of Athens (a reply to Papagrigorakis et al.) . International Journal of Infectious Diseases . 10 . 4 . 334–5; author reply 335–6 . July 2006 . 16730469 . 10.1016/j.ijid.2006.02.006 . free .
  19. Acuna-Soto R, Stahle DW, Cleaveland MK, Therrell MD . Megadrought and megadeath in 16th century Mexico . Emerging Infectious Diseases . 8 . 4 . 360–362 . April 2002 . 11971767 . 2730237 . 10.3201/eid0804.010175 .
  20. Web site: Salmonella May Have Caused Massive Aztec Epidemic, Study Finds . NRP . Hersher R . January 15, 2018 . January 15, 2018 . July 13, 2021 . https://web.archive.org/web/20210713002131/https://www.npr.org/sections/thetwo-way/2018/01/15/577681552/salmonella-may-have-caused-massive-aztec-epidemic-study-finds . live .
  21. Vågene ÅJ, Herbig A, Campana MG, Robles García NM, Warinner C, Sabin S, Spyrou MA, Andrades Valtueña A, Huson D, Tuross N, Bos KI, Krause J . 6 . Salmonella enterica genomes from victims of a major sixteenth-century epidemic in Mexico . Nature Ecology & Evolution . 2 . 3 . 520–528 . March 2018 . 29335577 . 10.1038/s41559-017-0446-6 . 2018NatEE...2..520V . 3358440 .
  22. Book: Byrne JP . Encyclopedia of Pestilence, Pandemics, and Plagues: A-M . ABC-CLIO . 2008 . 190 . 978-0-313-34102-1 . live . https://web.archive.org/web/20140103030250/http://books.google.com/books?id=5Pvi-ksuKFIC&pg=PA190&dq . January 3, 2014 .
  23. McHugh J, Mackowiak PA . Death in the White House: President William Henry Harrison's Atypical Pneumonia . Clinical Infectious Diseases . 59 . 7 . 990–995 . October 2014 . 24962997 . 10.1093/cid/ciu470 . free .
  24. News: What Really Killed William Henry Harrison?. Mchugh J, Mackowiak PA . March 31, 2014 . The New York Times. 0362-4331. January 19, 2017. live. https://web.archive.org/web/20170120002107/https://www.nytimes.com/2014/04/01/science/what-really-killed-william-henry-harrison.html. January 20, 2017.
  25. Armies of Pestilence: The Effects of Pandemics on History . James Clarke & Co. (2004). p.191.
  26. Web site: 1900 Flow of Chicago River Reversed . Chicago Timeline . Chicago Public Library . February 8, 2007 . https://web.archive.org/web/20070307091435/http://www.chipublib.org/004chicago/timeline/riverflow.html . March 7, 2007.
  27. Web site: Walter Reed Typhoid Fever, 1897–1911 . September 3, 2014 . live . https://web.archive.org/web/20141006125650/http://exhibits.hsl.virginia.edu/typhoid/ . October 6, 2014 ., Claude Moore Health Sciences Library. University of Virginia.
  28. Morabia . Alfredo . Hardy . Anne . The pioneering use of a questionnaire to investigate a food borne disease outbreak in early 20th century Britain . Journal of Epidemiology and Community Health . February 2005 . 59 . 2 . 94–99 . 10.1136/jech.2004.025700 . 15650138 . 0143-005X . 1733002 . July 7, 2024 . June 15, 2024 . https://web.archive.org/web/20240615104503/https://pubmed.ncbi.nlm.nih.gov/15650138/ . live .
  29. Web site: Emsworth Oysters . Emsworth Business Association . February 10, 2019 . https://web.archive.org/web/20160203191517/http://www.emsworth.org.uk/news/emsworths-oysters-video-now-online . February 3, 2016 . dead .
  30. Web site: Bulstrode HT . Dr. H. Timbrell Bulstrode's report to the Local Government Board upon alleged oyster-borne enteric fever and other illness following the mayoral banquets at Winchester and Southampton, and upon enteric fever occurring simultaneously elsewhere and also ascribed to oysters. HMSO. London. 1903. 1. https://web.archive.org/web/20190707184812/https://archive.org/stream/b24914812. July 7, 2019. dead.
  31. Web site: Nova: The Most Dangerous Woman in America . . live . https://web.archive.org/web/20100426042928/http://www.pbs.org/wgbh/nova/typhoid/letter.html . April 26, 2010 .
  32. Web site: en. 'Typhoid Mary' Dies of a Stroke at 68 – Carrier of Disease, Blamed for 51 Cases and 3 Deaths, but She Was Held Immune – Services This Morning – Epidemic Is Traced. The New York Times. November 12, 1938. May 14, 2020. https://web.archive.org/web/20200421173434/https://www.nytimes.com/1938/11/12/archives/typhoid-mary-dies-of-a-stroke-at-68-carrier-of-disease-blamed-for.html?searchResultPosition=12. April 21, 2020. live.
  33. Web site: en. Typhoid Mary's tragic tale exposed the health impacts of 'super-spreaders'. National Geographic. March 18, 2020. May 14, 2020. https://web.archive.org/web/20200501221757/https://www.nationalgeographic.co.uk/history-and-civilisation/2020/03/typhoid-marys-tragic-tale-exposed-health-impacts-of-super. May 1, 2020. live.
  34. info copied from Croydon typhoid outbreak of 1937; see that article for attribution and history
  35. Book: Pennington TH . When Food Kills : BSE, E.coli and disaster science: BSE, E.coli and disaster science. 2003. Oxford University Press. Oxford. 0-19-8525176 . 29–31.
  36. Holden OM . The croydon typhoid outbreak (A Summary of the Chief Clinical Features) . Public Health . October 1938 . 52 . 135–146 . 10.1016/S0033-3506(38)80123-2. 0033-3506.
  37. Book: Smith DF, Diack HL, Pennington TH, Russell EM . Food Poisoning, Policy, and Politics: Corned Beef and Typhoid in Britain in the 1960s. 2005. The Boydell Press. 1-84383-138-4. 13.
  38. Croydon Epidemic Inquiry . British Medical Journal . 1 . 4018 . 86–88 . January 1938 . 20781171 . 2085503 . 10.1136/bmj.1.4019.135 . 25368560 .
  39. Web site: Croydon Typhoid Outbreak of 1937. Goddard N. 29 November 2005. www.bbc.co.uk. 28 January 2020. August 20, 2021. https://web.archive.org/web/20210820015905/https://www.bbc.co.uk/radio4/history/making_history/making_history_20051129.shtml. live.
  40. Croydon Typhoid Inquiry: Mr. Murphy's Report . British Medical Journal . 1 . 4024 . 404–407 . February 1938 . 10.1136/bmj.1.4024.404 . 20781269 . 2085766 .
  41. Aberdeen typhoid outbreak of 1964 . British Medical Journal . 2 . 5514 . 601–602 . September 1966 . 5917376 . 1943458 . 10.1136/bmj.2.5514.601 . free .
  42. Web site: Records of Tor-na-Dee Hospital, Milltimber . University of Aberdeen (Special Collections) . 13 March 2020 . 3 May 2015 . https://web.archive.org/web/20150503141316/http://calms.abdn.ac.uk/DServe/dserve.exe?dsqServer=Calms&dsqIni=Dserve.ini&dsqApp=Archive&dsqCmd=Show.tcl&dsqDb=Catalog&dsqPos=0&dsqSearch=%28RefNo%3D%27grhb%2025%27%29 . dead .
  43. News: Extensively Drug-Resistant Typhoid Fever in Pakistan . Centers for Disease Control and Prevention . September 30, 2019 . December 9, 2019 . December 15, 2020 . https://web.archive.org/web/20201215225610/https://wwwnc.cdc.gov/travel/notices/watch/xdr-typhoid-fever-pakistan . live .
  44. Marchello CS, Carr SD, Crump JA . A Systematic Review on Antimicrobial Resistance among Salmonella Typhi Worldwide . EN . The American Journal of Tropical Medicine and Hygiene . 103 . 6 . 2518–2527 . December 2020 . 32996447 . 7695120 . 10.4269/ajtmh.20-0258 .

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