Typhoid Abdominalis

In typhus abdominalis – colloquially known as abdominal typhus – (synonyms: Abdomen typhus; abdominal typhus; intestinal typhus; Eberth’s disease; enteric fever; enteric fever; enterotyphus; febris enterica; gastroenteritic fever; infection by Bacterium typhosum; infection by Eberthella typhosa; Infection by Salmonella typhi; Status typhoides; Typhoenteritis; Typhogastric fever; Typhoid fever; Typhomania; Typhoperitonitis; Typhoid enteritis; Typhus abdominalis; ICD-10 A01. 0) is a systemic (affecting the entire organism) infectious disease caused by the bacterium Salmonella Typhi (Salmonella enterica ssp. enterica Serovar Typhi). The pathogens belong to the Enterobacteriaceae family. They are Gram-negative, motile and flagellated bacteria that are non-spore-forming and facultatively anaerobic. Pathogen reservoir is humans (possibly permanent excretors!). Occurrence: The infection occurs worldwide, especially in Africa, South America, Southeast Asia (especially India, Pakistan).

The so-called contagiousness index (synonyms: contagiousness index; infection index) was introduced to quantify the contagiousness (infectiousness or transmissibility of the pathogen) mathematically. It indicates the probability of a non-immune person becoming infected after contact with a pathogen. The contagiousness index for typhoid abdominalis is 0.50, meaning that 50 out of 100 unvaccinated persons will become infected after contact with a typhoid infected person. Transmission of the pathogen (route of infection) occurs through ingestion of contaminated food or water. Fecal-oral transmission (infections in which pathogens excreted in feces (fecal) are ingested through the mouth (oral)) is also possible. The incubation period (time from infection to onset of disease) is 3 to 60 days, usually 8-14 days. For Salmonella paratyphi infection, the incubation period ranges from 1 to 10 days. Sex ratio: males and females are equally affected. Frequency peak: the disease can occur at any age. One-year-old children and adolescents between 10 and 14 years of age are most commonly affected. The incidence (frequency of new cases) is 0.1 cases per 100,000 inhabitants per year. In Germany, the vast majority of cases (approximately 93%) are imported, with India reported as the most common country of infection. The worldwide annual incidence is estimated at approximately 22 million cases and 200,000 deaths. The duration of infectivity (contagiousness) may persist for several weeks after the symptoms have subsided.A survived typhoid infection leaves only a short-lived immunity. Course and prognosis: Early treatment is crucial for the course of the disease. Without antibiotic treatment, 2 to 5% of patients may become permanent excretors. The prognosis depends on the age of the patient and the nutritional and immune status. The lethality (mortality related to the total number of people suffering from the disease) is up to 20 % without therapy. If therapy is started in time, the lethality is less than 1%. Caution. In recent decades, a multidrug-resistant strain of typhoid pathogens has spread rapidly worldwide, displacing other typhoid strains and no longer responding to several standard antibiotics for therapy. Vaccination: Vaccination against typhoid fever is available. The STIKO (“Ständige Impfkommission”) recommends vaccination especially before traveling to the endemic areas of Asia, South America and North Africa, especially in simple living conditions, as well as during outbreaks or disasters. However, the vaccination does not provide complete protection (protection rate 50-70% in persons > 3 years), so that care must be taken to ensure appropriate hygiene when traveling to risk areas. In Germany, the disease (typhus abdominalis/paratyphoid) is notifiable according to the Infection Protection Act (IfSG). The notification must be made by name in the event of suspected illness, illness and death.