Typhoid is a systemic bacterial disease characterized by insidious onset of sustained fever, headache, malaise, anorexia, a relative bradycardia, splenomegaly, rose spots on the trunk, nonproductive cough, constipation more commonly than diarrhea in adults, and involvement of the lymphoid tissues. Case fatality of about 10% can be reduced to below 1% by prompt therapy. For para-typhoid, the case fatality is much lower. Relapses occur in approximately 3 to 4% of cases.
The etiologic organisms can be isolated from the blood early in the disease and from urine and feces after the first week. In cases treated with antibiotics, isolation in the bone marrow may still be possible. A fourfold rise in agglutination titer in paired sera appears during the second week in less than 70% of cases of typhoid fever. Because of its limited sensitivity, serology is of little diagnostic value.
According to the Ministry of Health, typhoid is diagnosed when there is "Insidious onset of sustained fever, headache, malaise, anorexia, relative bradycardia, splenomegaly, rose spots on the trunk, involvement of lymphoid tissue."
Based on this case definition, 11 cases were reported from the peripheral hospitals in the Riyadh region in 1997 and 14 in 1998. For the year 1997, the cases were reported sporadically. Only two weeks had slightly higher than expected incidence, two cases in week 22 and three in week 28. The number of reported cases in these two years was high from the city of Shagra, Wadi Al Dawaser (5 and 4 respectively).
The most common age group was 15 to 44 years, which had 63% of the patients in 1997, and 57% in 1998. In these two years, only one case was reported in the age group below 1 year (Al Aflaj), while two cases were reported from the age group 1 to 5 years (Shagra).
