Two confirmed cases of the typhoid fever have been reported in the U.S., including in Los Angeles and Boston. This sometimes life-threatening bacteria infects more than 20 million people worldwide, though it's rare in the U.S.

Typhoid fever is caused by Salmonella typhi bacteria. The bacteria are spread through contaminated food or water, and occasionally direct contact with someone who is infected. 

Symptoms may include:

• Headache
• Fever
• Weakness and fatigue
• Muscle aches
• Sweating
• Dry cough

Typhoid fever can be treated with antibiotics. Left untreated, it can be fatal to approximately 30% of those infected. It is usually diagnosed using blood and stool tests.

There are two types of vaccine to protect against typhoid. One is injected, while the other is given orally in capsule form. Vaccination is recommended for those who are in close contact with those with typhoid, and those who travel in areas where the virus is common, such as India, Southeast Asia, Africa and South America.

Vaccination for travelers is an important consideration, says Dr. Nipunie Rajapakse, an infectious diseases specialist at Mayo Clinic.

Watch: Dr. Nipunie Rajapakse talks about travel vaccines.

Journalists: The broadcast-quality sound bite with Dr. Rajapakse is in the downloads at the end of the post. Please "Courtesy: Mayo Clinic News Network."

"Different types of infections are present in different areas of the world. There are vaccinations that are available for some travel-related illnesses that you would not have received as part of your routine childhood or adulthood vaccines if you grew up in the U.S.," says Dr. Rajapakse. "Examples of this would be the yellow fever vaccine or typhoid vaccine, which are recommended for people traveling to certain areas of the world."

If you are planning to travel outside the U.S., see your health care provider or visit a travel clinic to discuss vaccination options and other measures you can take to stay safe and healthy while traveling. 

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