Typhoid Fever

What is typhoid fever?

Typhoid fever is a life-threatening bacterial infection caused by the bacterium Salmonella enterica serotype Typhi (S. Typhi). According to the Centers for Disease Control and Prevention (CDC), typhoid fever affects about 22 million persons in the world each year. The incidence of typhoid fever in U.S. citizens and residents who travel abroad is very low.

How is typhoid fever spread?

S. Typhi live only in humans, and are carried in the bloodstream and intestinal tracts of people who have typhoid fever. A small number of persons recover from typhoid fever but continue to carry the bacteria.

Both the carriers and the people who have active typhoid fever shed S. Typhi in their stools. Typhoid fever is spread by consuming food or beverages that have been handled by a person who is shedding S. Typhi, or if sewage contaminated with S. Typhi bacteria gets into water used for drinking or washing food.

What are the symptoms of typhoid fever?

When S. Typhi bacteria are consumed, they multiply and spread into the bloodstream. The body reacts with signs and symptoms such as:

  • a sustained fever as high as 102 to 104 degrees Fahrenheit (39 to 40 degrees Celcius)
  • weakness
  • stomach pains
  • headache
  • loss of appetite
  • sometimes a rash of flat, rose-colored spots

The symptoms of typhoid fever may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is typhoid fever diagnosed?

Typhoid fever can be diagnosed using a blood test or stool sample to determine the presence of S. Typhi bacteria.

How can typhoid fever be prevented?

A vaccination for typhoid fever is available. However, it can lose effectiveness after several years, so a booster vaccination may be necessary.

Other preventives for typhoid fever are:

  • only use water that has been boiled or chemically disinfected for:
    • drinking, or preparing beverages such as tea or coffee
    • brushing teeth
    • washing face and hands (can also use alcohol-based gel to wash hands)
    • washing fruits and vegetables
    • washing eating utensils and food preparation equipment
    • washing the surfaces of tins, cans, and bottles that contain food or beverages
  • do not eat food or drink beverages from unknown sources
  • do not put ice in drinks 
  • any raw food could be contaminated, including:
    • fruits, vegetables, salad greens
    • unpasteurized milk and milk products
    • raw meat
    • shellfish
    • any fish caught in tropical reefs rather than the open ocean

Taking antibiotics is not a preventive for typhoid fever.

Treatment for typhoid fever:

See your physician immediately if you think you have been exposed to typhoid fever. People who do not get treatment may continue to have fever for weeks or months, and may eventually die from complications. Treatment will probably include an antibiotic to treat the disease. Specific treatment for typhoid fever will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

It is important to remember that the danger of typhoid fever does not end when symptoms disappear. You could still be carrying S. Typhi and the illness could return, or you could pass the disease to other people. People who have typhoid fever should:

  • take any prescribed antibiotics.
  • wash your hands after using the bathroom.
  • have a series of stool cultures - to ensure that the S. Typhi bacteria are no longer present.

Typhoid fever and the traveler:

Typhoid fever is very common in the developing countries and travelers to Asia (except Japan), Africa, and Latin America are especially at risk. The Centers for Disease Control (CDC) recommends, when traveling to an area where typhoid fever is common, vaccinations should be considered one week prior to traveling.

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