Current concepts in the diagnosis and treatment of typhoid fever

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Abstract
Few established surveillance systems for typhoid exist in the developing world, especially in community settings, so the true burden is difficult to estimate. This is shown by recent revisions in the global estimates of the true burden of typhoid. In contrast to previous estimates, which were 60% higher,1 investigators from the US Centers for Disease Control and Prevention estimate that there are 21.6 million typhoid cases annually, with the annual incidence varying from 100 to 1000 cases per 100 000 population.2 The global mortality estimates from typhoid have also been revised downwards from 600 000 to 200 000, largely on the basis of regional extrapolations.2 Recent population based studies from South Asia suggest that the incidence is highest in children aged less than 5 years, with higher rates of complications and hospitalisation, and may indicate risk of early exposure to relatively large infecting doses of the organisms in these populations.3–5 These findings contrast with previous studies from Latin Americaw1 and Africa,w2 which suggested that S typhi infection caused a mild disease …