Typhoid an acute infectious fever caused by a gram-negative, motile bacillus Salmonella typhi. Typhoid is highly prevalent in the tropical countries but may occur anywhere. In Bangladesh it occurs as an endemic disease. Its prevalence is higher after the rainy season but occurs throughout the year. In rural areas and in areas with poor sanitation, overcrowding, unhealthy environment, and lack of safe water supply, its prevalence is higher. Poor public health measures is one of the main contributory factors for its occurrence and spread.

The disease occurs due to ingestion of contaminated food or drink. Stale food and impure water contaminated with typhoid bacilli usually cause the disease. The contamination occurs from typhoid patient's stool or other contaminated materials.

The disease has insidious onset with malaise, headache, lack of appetite, and nausea. This is followed by fever. The temperature starts slowly, and gradually reaches its peak (often to 105ºF) in second week and may continue for three weeks, and the patient recovers during the 4th week with sudden remission of fever. Occasionally the patient may develop complications and may die. The main complications are bleeding from stomach, distension of abdomen, or even intestinal perforations with peritonitis (which is usually fatal). Sometimes the patient may develop diarrhoea, and vomiting. However, with modern treatment facilities, typhoid is completely curable and preventable with improved public health measures. Anti-typhoid vaccination has also a substantial role in the prevention of typhoid.

Typhoid is prevalent more in the rural areas of Bangladesh than the urban areas. Poor public health services could be the reason for this. In cities however, the disease is found more among the slum and Basti dwellers. Both sexes are equally affected. The disease occurs more in young adults. There are cases of drug resistant typhoid occurring in Bangladesh due to improper and irregular treatment, which needs special care and attention. [Md. Serajul Islam]