TYPHOID FEVER - An infectious febrile illness usually spread by contamination of food, milk, or water supplies with Salmonella typhi, either directly by sewage, indirectly by flies, or by faulty personal hygiene. There are less than 600 cases per year in the US. Asymptomatic carriers harbor the organism in their gallbladder and excrete it in their stools for years. Average incubation time is 10-14 days. Fever, diarrheal stools (often bloody), abdominal pain, malaise, and a rose colored rash on the upper abdomen are seen. Severe cases may progress to delirium and obtundation. Complications include glomerulonephritis. Treatment includes intravenous fluids and antibiotics (chloramphenicol or ampicillin). Vaccines are recommended for travel to endemic areas.