Background Typhoid fever (enteric fever) is caused by Salmonella typhi which is solely a human pathogen with no known animal reservoir. S. typhi is a gram-negative, motile, rod-shaped and facultative anaerobic bacterium. 1 It is a non-spore forming and non-lactose fermenting bacterium. The bacterium is transmitted mainly through consumption of food and water that has been contaminated by faecal matter. 2 Clean water, good hygiene and sanitation are factors that prevent the spread of typhoid. 1,3,4 The incubation period is usually 1-2 weeks, and the duration of the illness is about 3-4 weeks. Symptoms include poor appetite, headaches, generalized aches and pains, fatigue, weakness, fever as high as 103 o to 104 o F (39°C to 40°C), lethargy, diarrhoea and rose coloured spot. 5,6 Salmonella typhi infection begins with colonization of the small intestine, which progresses to the invasion of the gastrointestinal mucosa. The infection then spreads to the liver, spleen, and bone marrow. 1,7 The severity of the infection depends on the initial infective dose, virulence and the host's immune response. 8-10 The greatest burden of disease is experienced by infants, children and adolescents (the World Health Organization [WHO] 11 and Crump and Mintz 12). In view of the above, the WHO recognizes this disease as a major public health problem and recommends immunization with Vi polysaccharide vaccine in high-risk areas. 13 Typhoid fever is an endemic disease in tropical and subtropical climates and has become a major public health problem in developing countries, with an estimated annual incidence of 540 cases per 100 000 people, and an estimated 17 million cases worldwide. 11,14 It is often encountered in tropical countries including Nigeria where it constitutes a serious source of morbidity and mortality. 15,16 This stems from poor hygienic environment and inadequate water supply systems which have become