Typhim Vitrade mark Vaccine.
Long before the term "Typhoid Mary" entered the vernacular in the early 1900s, investigators such as Huxham1 in 1782 and Schoenlein2 in 1839 had already differentiated typhoid fever-the typhus-like fever caused by Salmonella typhi-from other prolonged febrile syndromes such as rickettsial typhus fever.3 The notorious Mary Mallon had been identified as a carrier of the typhoid fever bacillus in 1907; by the time she was captured 8 years later, she had infected at least 50 people (causing the death of three) while working as a New York City cook under several assumed names.4 Even though the incidence of this serious infection has obviously decreased since 1900 in developed countries, it continues to be prevalent in developing countries. Consequently, most cases reported in the United States occur in international travelers. Prevention is critical because typhoid fever is associated with a high rate of complications, its course can be severe and prolonged, and multidrug-resistant strains have recently emerged.5
Fanning
WL
Director, The Scottsdale Medical Travel Clinic, Scottsdale, Arizona.