TRAVEL ABROAD Typhoid fever poses danger in poor areas

ALEXANDRIA, Va. (AP) -- Boil it, cook it, peel it or forget it.
Those are the guidelines provided by the Centers for Disease Control and Prevention for safe consumption of food and drink in developing countries.
Diarrhea is a common but relatively minor ailment among travelers who are exposed to contaminated food, but the July 15 issue of Clinical Infectious Diseases warns of a more serious risk: typhoid fever.
Three-fourths of the cases of typhoid fever examined by the study were associated with international travel, and six countries -- India, Pakistan, Mexico, Bangladesh, the Philippines and Haiti -- were the source of 76 percent of those illnesses.
Consider vaccination
If you're headed to one of these countries, you may want to consider getting vaccinated against typhoid before you go. The vaccine takes a week to become effective, but immunity lasts five years.
Dr. Ellen Steinberg Stevenson of the CDC says most travelers are probably unaware of the risks of the disease, which may be fatal if left untreated. Symptoms include fever, rash, stomachache, slowed pulse, enlarged spleen and delirium.
A single contaminated food item -- whether it's shellfish harvested from sewage-tinged mud or a snack from a street vendor with dirty hands -- can cause the illness. Five percent of the typhoid fever patients in the study had traveled abroad for a week or less, and more than a third had spent a month or less.
"You could ingest it on the first day you arrive or after being there for a few months," the doctor said.
The study looked at 1,400 typhoid fever cases reported in the United States between 1994 and 1999.
More information
For more information on typhoid fever and how to avoid it, visit www.cdc.gov/ncidod/dbmd/diseaseinfo/typhoidfever--g.htm and www.cdc.gov/travel/disease/typhoid.htm.