Typhoid is usually spread when food or water has been infected with Salmonella typhi, most often through contact with the feces of an infected person. Once the typhoid bacteria enter the bloodstream, the body mounts a defense that causes a high fever, headache, stomach pains, weakness and decreased appetite.
Occasionally, people who have typhoid get a rash of flat, red spots. Because sewage treatment in the United States is quite good, the disease is very rare, and the CDC reports only about 400 cases of it annually. However, people who live in developing countries where there is little water and sewage treatment, or where hand washing isn't a common practice, are at high risk. Prime typhoid fever areas are in Africa, Asia, the Caribbean, India and Central and South America.
WHO estimates 17 million cases occur globally with 600,000 deaths each year. Despite these daunting statistics, typhoid fever vaccination is available for people who travel to high-risk areas, and the disease can be effectively treated with antibiotics. Without treatment, the fever can continue for weeks or months, and the infection can lead to death.