4 questions—and answers—about typhoid fever

A North Quincy daycare center shut down this week after a child was diagnosed with the disease.

Female doctor holding application form while consulting patient; Shutterstock ID 158366573; PO: essay
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A child care center in North Quincy shutdown this week after one of its students was diagnosed with typhoid fever.

Health officials say the child attending the Bright Horizons Daycare had recently traveled abroad.

Omar Cabrera, a spokesman for the state Department of Public Health, said each year Massachusetts sees some cases of typhoid. In 2017, 20 cases were identified.

“The Massachusetts Department of Public Health is working with Bright Horizons and the Quincy Public Health Department to prevent the spread of the disease,” he said in a statement.

According to the state agency, people who have been exposed to the Salmonella Typhi bacteria may become sick three days to two months after becoming exposed, though most people start feeling sick within a week or two.

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We talked with Dr. Mary Montgomery, an infectious disease physician at Brigham and Women’s Hospital, to learn more about the disease that the Centers for Disease Control and Prevention describes as a “life-threatening illness.”

“It’s extremely rare to get it in the United States, and most cases are acquired in places in the world with poor sanitation,” she said of the disease.

What are the symptoms of typhoid fever?

A high fever is just one symptom of the disease.

“It can also be associated with a rash, abdominal pain, and, sometimes, with diarrhea,” Montgomery said. “Most cases of typhoid fever that we do see here in the United States are amongst people who have traveled to other parts of the world.”

How contagious is it?

“It can be contagious but not super contagious,” the doctor said. “It is spread by children or adults ingesting the bacteria. The way to prevent it is good hand hygiene. It’s really coming in contact with the stool of the [person] that’s infected.”

What is the treatment?

Montgomery said, once diagnosed, the illness is treated with up to two weeks of antibiotics.

“Here in the United States there’s a very low mortality rate with effective treatment,” she said. “In other parts of the world where access to medical care and access to appropriate antibiotics is limited, typhoid fever has led, and continues to lead, to many deaths.”

How concerned should people be that a case was diagnosed in Quincy?

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The Brigham physician said people “should not be concerned.”

“This is likely a case of typhoid fever that was acquired while the child was recently traveling abroad,” Montgomery said. “The daycare is taking the necessary precautions to limit any exposure to any other children or daycare providers.”

If you are planning to travel abroad in south central or southeast Asia, Africa, parts of Latin American, or the Caribbean, she recommends taking protective measures against the infection by getting the vaccine at a travel clinic.

“People should really be concerned about preventing typhoid fever when they travel,” Montgomery said. “That is the reason why we always advise people to — in areas of poor sanitation — to drink only bottled water, to wash their hands, to ideally only eat cooked food and to avoid raw food, such as salads, that can be contaminated with the tap water.”