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Typhoid fever has infected many people and was responsible for many deaths over the course of history, which continues to a lesser extent today.
The pathogen responsible for the disease was not established until late in the 19th century and the first effective vaccination was introduced approximately one year later. This had a notable effect on the incidence of typhoid fever, particularly for highly susceptible populations, such as those serving in the military.
It is difficult to determine the cause of plagues and infectious diseases in early history, although some speculation is usually allowed.
Some historians believe that typhoid fever was responsible for a widespread plague in Athens in 430BC, which proved fatal for one third of the population, including the leader at the time, Pericles. His successor, Thucydides, also contracted the same disease, although it did not prove fatal.
Jamestown, an English colony in Virginia, is also thought by some historians to have died out as a result of typhoid fever. The fever proved fatal for more than 6000 settlers between 1607 and 1624, and may have been responsible for eliminating the entire colony.
Military and war environments have often been subjected to the presence of typhoid fever throughout history. In excess of 80,000 soldiers died as a result of typhoid fever or dysentery in the American Civil War. Likewise, the Spanish-American War led to infections with typhoid both on the field and in training camps.
Mary Mallon, also commonly known as Typhoid Mary, was the most widely known carrier of typhoid fever. She was the first person in the United States to be identified as a carrier of the pathogen responsible for the disease, without experiencing symptoms related to the condition.
She worked as a cook and throughout her career is thought to have infected 51 people, of which 3 cases proved fatal. She was forcibly isolated for quarantine purposes twice in her life, once in 1907 and again in 1915. The second time she was not released and she died in isolation at the age of 69.
William Budd was an English doctor responsible for treating an outbreak of typhoid in 1838, when he noted that the poison, as he then called it, was present in the excretions of the infected and could be transmitted to healthy people through contaminated water consumption. Upon realizing this association, he suggested isolating excrement to help control future outbreaks.
Karl Joseph Eberth was the first to describe the bacillus that was suspected to cause typhoid in 1880. Four years later, Georg Gaffky was a pathologist that confirmed this link, naming the bacillus Eberthella typhi, which is known today as Salmonella enterica.
The first effective vaccine for typhoid was developed by Almroth Edward Wright and was introduced for military use in 1896. This made a significant improvement to the health of soldiers at war, who were more likely to be killed by typhoid than in combat at that time. This vaccine was further developed over the following years in London.
Throughout the 20th century, the incidence of typhoid fever steadily declined, which was due to the introduction of vaccinations and improvements in public sanitation and hygiene. In particular, the chlorination of drinking water made a significant impact on the number of individuals affected by the disease.
Today, typhoid fever is considered a rare condition among developed countries, with an incidence rate of approximately five cases per million per year.