Typhoid: Carrying the disease but showing no symptoms

Typhoid fever is a serious infectious disease caused by the bacterium Salmonella enterica serotype Typhi. It spreads primarily through contaminated food and water, making it common in areas with poor sanitation.

The symptoms of typhoid usually develop 1-3 weeks after exposure and include prolonged high fever, weakness, stomach pain, headache and sometimes a rash of flat, rose-coloured spots. If untreated, complications like gut bleeding or perforation can occur, making timely diagnosis and treatment critical.

Historically, typhoid was a significant cause of illness and death, especially before modern sanitation and antibiotics. It was common during wars and in crowded urban areas until the early 20th century.

The famous case of “Typhoid Mary” highlighted the role of asymptomatic carriers—people who harbour and spread a disease without showing symptoms themselves. Mary worked as a cook in New York and unknowingly transmitted typhoid to many people. Once identified, she was prevented from working ever again to stop further infections, and forced to spend the rest of her life in quarantine. She died in 1938, having lived for nearly 30 years in isolation.

Asymptomatic carriers also play an important role in the spread of other diseases, for example polio, hepatitis B, tuberculosis and COVID-19.

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