EpidemiologyĪn estimated 11–21 million cases of typhoid fever and 5 million cases of paratyphoid fever occur worldwide each year, causing an estimated 135,000–230,000 deaths. Sexual contact, particularly among men who have sex with men, has been documented as a rare route of transmission. Risk for infection is high in low- and middle-income countries with endemic disease and poor access to safe food and water, and poor sanitation. Typhoid and paratyphoid fever are acquired through consumption of water or food contaminated by feces of an acutely infected or convalescent person, or a person with chronic, asymptomatic carriage. Humans are the only source of the bacteria that cause enteric fever no animal or environmental reservoirs have been identified. For more details on nontyphoidal salmonellosis, see the Sec. L(+) tartrate(+), ferments tartrate and is associated with gastroenteritis typical of nontyphoidal salmonellosis. ![]() Paratyphi B strains are differentiated into 2 distinct pathotypes on the basis of their ability to ferment tartrate: the first pathotype, Paratyphi B, is unable to ferment tartrate and is associated with paratyphoid fever the second pathotype, Paratyphi B var. ![]() Salmonella enterica serotypes Typhi, Paratyphi A, Paratyphi B, and Paratyphi C cause potentially severe and occasionally life-threatening bacteremic illnesses referred to as typhoid fever (for Typhi serotype) and paratyphoid fever (for Paratyphi serotypes), and collectively as enteric fever. ![]() A clinical laboratory certified in moderate complexity testing state health department Infectious Agent
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