Enteric fever is the inclusive term for both typhoid and paratyphoid fevers with typhoid fever being the more common disease in most parts of the world. Typhoid fever is caused by Salmonella typhi, a bacterial infection acquired by ingestion of food or water contaminated with waste (e.g. feces) from a patient with typhoid fever or from a convalescing or chronic carrier of typhoid. Human beings are the only known reservoir. S. typhi, unlike other Salmonella species, possesses a polysaccharide Vi (virulence) surface antigen, which enhances its invasiveness. The disease remains endemic because of inadequate sewage disposal and lack of safe water supplies, mostly in the developing world. The most recent statistics indicate there were 21 million cases of typhoid fever worldwide with 200 000 deaths in 2000 (Crump et al., 2004). Obtaining accurate data on disease burden in developing countries is difficult because the diagnosis of typhoid fever is often a clinical one, without blood culture confirmation, and public health figures may underestimate levels compared with community based studies (Connor & Schwartz, 2005). 90% of typhoid fever cases reportedly occur in children between the ages of 3 and 19 years and they usually experience the most severe illness (Ivanoff et al., 1994). About 70% of all fatalities resulting from this disease occur in Asia. When infections occur in developing countries, they generally result in mass outbreaks due to sewage and poor sanitation. In 1996–1998, for example, a large outbreak of typhoid fever occurred in Tajikistan, resulting in more than 24 000 cases. Industrialized countries, in contrast, generally experience single cases of typhoid fever from travelers returning from other countries. Studies have shown that children aged one to twelve tend to be most susceptible to this infection and experience the most severe illness (World Health Organization, 2003). S. typhi is spread through food and water supplies that have been contaminated by human urine or fecal matter containing the bacterium. The bacterium enters the human body via the fecal-oral route. Upon ingestion, the bacterium may enter the reticuloendothelium and multiply intracellulary within macrophages. Entry of bacteria into the bloodstream marks the onset of clinical typhoid fever. During the second or third week of the illness, heavy re-infection of the gut occurs through bile or bacteraemic spread (Grant et al., 2001). Diagramed below is the route that the S. typhi pathogen takes upon infection. Symptoms: The incubation period is usually about 10 to 14 days but can last as long as 60 days after ingestion of the bacteria. The disease has few physical signs but the most prominent symptom of this systemic infection is prolonged fever. A prodrome of nonspecific symptoms often precedes fever and includes chills, headache, anorexia, cough, weakness, sore throat, dizziness, and muscle pains. Gastrointestinal symptoms are quite variable. Patients can present with either diarrhea or constipation; diarrhea is more common among patients with AIDS and among children These spots are most often observed on the upper abdomen and lower chest. The rash occurs in less than 10% of patients and is easily missed in dark-skinned people. Abdominal tenderness and distension are common as the disease progresses (Connor & Schwartz, 2005). Some people infected with S. typhi, do not exhibit any symptoms or they continue to shed S. typhi in their feces after they have recovered. These individuals are known as chronic carriers and despite their health must remain careful with their personal hygiene so as not to infect others. Treatment: Antibiotic therapy is successful against uncomplicated typhoid and once therapy begins, rapid improvement in the patient's condition is usually seen though complete healing takes one week. Without treatment, infected persons will generally continue to experience a fever for weeks or months (Grant et al., 2001). However some therapies are not successful due to the emergence of multidrug resistance. Multidrug-resistant strains (strains of S. typhi resistant to many drugs) have caused several outbreaks of typhoid fever in many developing regions, especially China and India where 50-80% of isolates are multidrug resistant (Gupta 1994). Multidrug-resistant strains have also been isolated with increasing frequency in developed countries from returning travelers. Increasing resistance in recent years led to the use of quinolone derivatives, for which drug resistance has also increased, and third-generation cephalosporins (World Health Organization, 2003). Multidrug resistance is a growing crisis around the world. It increases the cost of treatment, leaves it less effective and results in higher stool carriage rates with a greater transmission potential, posing public-health risks (Connor & Schwartz, 2005). The cost increase also means treatment is more difficult to access in the developing world. Prevention: Proper sewage disposal and hand washing are crucial for the prevention of this disease (World Health Organization, 2003). Proper nutrition can also decrease a person’s susceptibility to typhoid fever by preventing the alteration of intestinal flora or other host defenses that occurs through malnutrition. There are two currently-licensed typhoid vaccines that have conferred protective efficacy rates of approximately 60-70%, without significant side-effects. One is a parenteral vaccine based on the purified Vi polysaccharide and the other is a live, attenuated vaccine that is administered orally. Although there have not been very many controlled trials in this area, from preliminary research, it appears that both vaccines induce protective immunity for several years and that large-scale vaccination could help in control of the disease (World Health Organization, 2003).