Typhoid fever epidemiology and demographics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Aslam, M.B.B.S[2]

An estimated 16-33 million cases of typhoid result in 500,000 to 600,000 deaths annually. In 2000, typhoid fever caused an estimated 21.7 million illnesses and 217,000 deaths.^[1][2] Worldwide, typhoid fever is most prevalent in overcrowded areas with poor hygiene and sanitation. Typhoid fever is still common in the developing world, where it affects about 21.5 million people each year. 1-6% of the individuals who are infected will develop a chronic infection of the gall bladder.^[3] The incidence of typhoid fever varies in different parts of world.^[4][5][6] Age, race, gender and certain environmental factors affect the distribution of disease among these groups.^[7][8][9]

• An estimated 16-33 million cases of typhoid result in 500,000 to 600,000 deaths annually.
• In 2000, typhoid fever caused an estimated 21.7 million illnesses and 217,000 deaths.^[1][2]
• In 2013, typhoid fever resulted in about 161,000 deaths as compared to 181,000 in 1990.^[10][11]

• Worldwide, typhoid fever is most prevalent in overcrowded areas with poor hygiene and sanitation.
• In endemic areas, the World Health Organisation identifies typhoid as a serious public health problem.
• Typhoid fever is still common in the developing world, where it affects about 21.5 million people each year.
• Typhoid fever is common in the most parts of the world except in the industrialized regions such as the United States, Canada, Western Europe, Australia, and Japan.
• 1-6% of the individuals who are infected will develop a chronic infection of the gall bladder.^[12][3]

The incidence of typhoid fever varies in different parts of world.^[4][5][6]

• Areas with the highest incidence of typhoid fever (>100/100,000 cases/year) include south-central Asia and south-east Asia.^[13].
• Areas with the medium incidence (10-100/100,000 cases/year) include the rest of Asia, Africa, Latin America and the Caribbean, and Oceania, except for Australia and New Zealand^[13]
• Areas with the low incidence (<10/100,000 cases/year) include Europe, North America, and the rest of the world.^[13]
• The incidence of typhoid fever is estimated to be less than 400 cases per year in the United States and 75% of these are acquired while travelling internationally.^[14]

• The case fatality rate for typhoid fever is 1%.^[15]

The following demographic factors may affect the incidence and prevalence of typhoid fever.

The incidence of typhoid fever is highest in children between the ages of 5 and 19 years.^[7][8][9]

There is no racial predilection for typhoid fever.

Males are more commonly affected with the typhoid fever than females. The male to female ratio is approximately 1.36 to 1.^[8]

The incidence of typhoid fever increases with an increase in temperature and rainfall.^[8]

Typhoid fever is sporadic in developed countries but may be seen in travellers returning from endemic areas. The incidence of typhoid fever in the United States has been stable at about 200-300 cases in 2013.^[16]

The incidence and prevalence of typhoid fever is highest in developing countries.^{[8][2][17][9]} The incidence of typhoid fever in the Mekong Delta region of Vietnam and Delhi in India is approximately 198 per 100,000 and 980 per 100,000 per year, respectively, based on recent reports.^[18][19]

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