<Tr> <Th> Deaths </Th> <Td> 149,000 (2015) </Td> </Tr> <P> Typhoid fever, also known simply as typhoid, is a bacterial infection due to Salmonella typhi that causes symptoms . Symptoms may vary from mild to severe and usually begin six to thirty days after exposure . Often there is a gradual onset of a high fever over several days . Weakness, abdominal pain, constipation, and headaches also commonly occur . Diarrhea is uncommon and vomiting is not usually severe . Some people develop a skin rash with rose colored spots . In severe cases there may be confusion . Without treatment, symptoms may last weeks or months . Other people may carry the bacterium without being affected; however, they are still able to spread the disease to others . Typhoid fever is a type of enteric fever along with paratyphoid fever . </P> <P> The cause is the bacterium Salmonella Typhi, also known as Salmonella enterica serotype Typhi, growing in the intestines and blood . Typhoid is spread by eating or drinking food or water contaminated with the feces of an infected person . Risk factors include poor sanitation and poor hygiene . Those who travel to the developing world are also at risk and only humans can be infected . Diagnosis is by either culturing the bacteria or detecting the bacterium's DNA in the blood, stool, or bone marrow . Culturing the bacterium can be difficult . Bone marrow testing is the most accurate . Symptoms are similar to that of many other infectious diseases . Typhus is a different disease . </P> <P> A typhoid vaccine can prevent about 30% to 70% of cases during the first two years . The vaccine may have some effect for up to seven years . It is recommended for those at high risk or people traveling to areas where the disease is common . Other efforts to prevent the disease include providing clean drinking water, good sanitation, and handwashing . Until it has been confirmed that an individual's infection is cleared, the individual should not prepare food for others . Treatment of disease is with antibiotics such as azithromycin, fluoroquinolones or third generation cephalosporins . Resistance to these antibiotics has been developing, which has made treatment of the disease more difficult . </P>

Where does salmonella typhi live in the body