A serious infection caused by the bacterium Salmonella typhi. A similar clinical picture can be caused by the agent responsible for a form of paratyphoid. Infection can be transmitted by unboiled milk, water or by food infected by a carrier. The disease begins after an incubation period of about 7 to 14 days, with headaches, swollen abdomen and Abdominal typhoid fever has many symptoms which seem to point to other infections. Abdominal pain, nausea, and diarrhoea, sometimes preceded by constipation. The body temperature gradually rises in the course of the first week to over 40°C. A skin rash and red spots (roseola) sometimes appear in the second week. In some cases, typhoid can cause an inflammation of the cerebral membrane or pneumonia. Serious complications are possible, such as intestinal bleeding or intestinal perforation. When a physical examination is performed, a relatively slow pulse and an enlarged spleen are detected. In a laboratory examination, the striking feature is that there is a low count of white blood cells (in most infections the number of white blood cells increases). Antibodies which attack the causative agent can also be found. The bacteria can be quickly detected by means of a blood culture; in the stools, they do not occur until much later. Good hygiene, specifically good drainage and a good supply of drinking water, is the key to preventing typhoid. Treatment consists of antibiotics (chloramphenicol), supplemented by a mild diet and extra fluid. Thanks to antibiotics, the mortality rate is very low.