Typhoid Fever

What is typhoid fever?

Typhoid fever is a serious infection caused by a type of bacteria. It is more common in Africa, Latin America, and Asia (especially in Southeast Asia), but less so in the U.S. Most cases in this country are in people who got the disease while traveling outside of the U.S.

You can get the disease by eating food or drinking water that is contaminated with the bacteria.

What causes typhoid fever?

Typhoid fever is caused by the bacteria Salmonella Typhi. The bacteria are passed on by eating food or drinking water that has been contaminated by someone with the disease or who is a carrier of the infection. The bacteria are found in the infected person’s stool. They may get onto the person's hands or other parts of the body if there are poor hygiene practices. You can also get the disease if water used for drinking or washing food is contaminated with sewage containing the bacteria.

People who recover from typhoid fever can sometimes still have the bacteria in their stool and can pass them on to other people. They are called "carriers."

What are the symptoms of typhoid fever?

Once the bacteria are in your body, they increase in number and spread into your blood. You may not have symptoms for 6 to 30 days after the first exposure. Symptoms may include:

• Fever from 102°F to 104°F (39°C to 40°C)

• Weakness

• Belly (abdominal) pains

• Headache

• Loss of appetite

• Sometimes a rash of flat, pink or rose-colored spots

• Constipation, vomiting, or diarrhea

The symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

How is typhoid fever diagnosed?

Your healthcare provider will use blood tests or a stool sample to diagnose typhoid fever. These tests can find the typhoid bacteria. But these tests are less accurate if you have just come down with the disease. Because of this, your provider will also look at your symptoms and travel history.

How is typhoid fever treated?

See your healthcare provider right away if you think you have any of the symptoms of typhoid fever. Most otherwise healthy adults get better on their own. But some people who are not treated may have a fever for weeks or months. And sometimes the germ can spread to other parts of the body and cause serious complications.

Antibiotics are often needed to treat typhoid fever.

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

It is important to remember that the danger of typhoid fever does not end when symptoms go away. You could still be carrying the bacteria. The illness could also return. Or you could pass the disease to other people. You should:

• Take any antibiotics exactly as your healthcare provider tells you to

• Always wash your hands after using the bathroom

• Have a series of stool cultures. This is to make sure that the bacteria are no longer in your body

What are possible complications of typhoid fever?

Complications of typhoid fever include intestinal bleeding, persistent fever and weakness, and spread of the germ to various parts of the body. The complications can sometimes be life-threatening.

Once your symptoms are gone, you may still have the typhoid bacteria in your body. Follow up with your healthcare provider to make sure the bacteria are completely gone and that you are not still a carrier. You will also need to practice good hygiene. Wash your hands before and after you use the bathroom. You should also not make food for anyone else until the bacteria are gone.

What can I do to prevent typhoid fever?

Typhoid fever is very common in developing countries. Travelers to Africa, Latin America, and Asian countries—except Japan—are at highest risk.

Two types of typhoid vaccines are available. One is a pill and one is a shot. A vaccine will be advised if you are traveling to high-risk locations or engaging in higher-risk activities while there. The best time to get the shot is 2 weeks before traveling. A booster shot is advised every 2 years for people who are at high risk.

Typhoid vaccines are not 100% effective. Use the tips below and always practice safe eating and drinking habits when traveling.

You can also prevent typhoid fever when traveling by:

• Only using water that has been boiled or chemically disinfected for drinking or making beverages, such as tea or coffee, and for brushing teeth

• Washing your face and hands. You can also use an alcohol-based gel to clean your hands.

• Washing and peeling fruits and vegetables

• Washing eating utensils, pots, and pans

• Washing the surfaces of tins, cans, and bottles that contain food or beverages before opening them

Also don't eat food from street vendors. Any raw food could be contaminated. Stay away from:

• Fruits and vegetables, particularly those that cannot be peeled 

• Salad greens 

• Unpasteurized milk and milk products

• Raw meat

• Shellfish

• Any fish caught in tropical reefs rather than the open ocean

Other tips for prevention:

• Don't eat food or drink beverages from unknown sources.

• Don't put ice in drinks.

• Stay away from overcrowded areas

• Make sure food is correctly cooked and still hot when served

When should I call my healthcare provider?

Call your healthcare provider right away if your symptoms return or get worse, or you have new ones.

Key points about typhoid fever

• Typhoid fever is a serious infection caused by bacteria.

• In the U.S., most cases are in people who get the disease while traveling in other countries.

• Symptoms include a high fever, weakness, belly pains, headache, and loss of appetite. Sometimes, a rash of flat, rose-colored spots may appear.

• Antibiotics are often used to treat the disease.

• To prevent typhoid fever, drink only boiled or chemically disinfected water. Also do not eat raw food that could be contaminated.

• Talk to your healthcare provider about getting the typhoid vaccine if you will be traveling to a high-risk area.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.