Typhoid fever is a serious bacterial infection that easily spreads through contaminated water and food. Along with high fever, it can cause abdominal pains, headache, and loss of appetite.
Typhoid fever may also be referred to as typhoid.
With treatment, most people make a full recovery. But untreated typhoid can lead to life threatening complications.
It can take a week or two after infection for symptoms to appear. Some of these symptoms are:
Serious complications are rare but can include intestinal bleeding or perforations in the intestine. This can lead to a life threatening bloodstream infection (sepsis). Symptoms include nausea, vomiting, and severe abdominal pain.
If you have any of these symptoms, tell your doctor about any recent travels you may have taken outside the country.
Typhoid is caused by bacteria called Salmonella typhi (S. typhi). It’s not the same bacterium that causes the foodborne illness salmonellosis (salmonella).
The main method of transmitting S. typhi is the oral-fecal route, generally spreading in contaminated water or food. It can also be passed through direct contact with a person who has a typhoid infection.
Some regions have a higher incidence of typhoid. These include:
- South America
- Southeast Asia
When traveling to countries that have higher incidences of typhoid, it helps to follow these prevention tips:
Be careful about what you drink
- Don’t drink from the tap or a well.
- Avoid ice cubes, popsicles, or fountain drinks unless you’re certain they’re made from bottled or boiled water.
- Buy bottled drinks whenever possible (carbonated water is safer than noncarbonated water, be sure bottles are tightly sealed).
- Nonbottled water should be boiled for 1 minute before drinking.
- It’s safe to drink pasteurized milk, hot tea, and hot coffee.
Watch what you eat
- Don’t eat raw produce unless you can peel it yourself after washing your hands.
- Avoid food from street vendors.
- Don’t eat raw or rare meat or fish. Foods should be thoroughly cooked and still hot when served.
- Eat only pasteurized dairy products and hard-cooked eggs.
- Avoid salads and condiments made from fresh ingredients.
- Don’t eat wild game.
Practice good hygiene
- Wash your hands often, especially after using the bathroom and before touching food (use lots of soap and water if available — if not, use hand sanitizer containing at least 60 percent alcohol).
- Don’t touch your face unless you’ve just washed your hands.
- Avoid direct contact with people who are sick.
- If you’re sick, avoid other people, wash your hands often, and don’t prepare or serve food.
For most people in good overall health, the typhoid vaccine is not necessary. But your doctor might recommend one if you’re:
- a carrier (someone who’s asymptomatic but can still spread the bacteria that causes typhoid)
- in close contact with a carrier
- traveling to a country where typhoid is common
- a laboratory worker who may come in contact with S. typhi
The typhoid vaccine is 50 to 80 percent effective and comes in two forms:
- Inactivated typhoid vaccine. This vaccine is a one-dose injection. It’s not for children younger than 2 years old, and it takes about 2 weeks to work. You can have a booster dose every 2 years.
- Live typhoid vaccine. This vaccine is not for children under age 6. It’s an oral vaccine given in 4 doses, 2 days apart. It takes at least a week after the last dose to work. You can have a booster every 5 years.
A blood test can confirm the presence of S. typhi. Typhoid is treated with antibiotics such as:
Resistance to antibiotics is increasing in some strains that cause typhoid. In Pakistan, one emerging strain known as XDR has become resistant to all but two antibiotic classes usually used for treatment of typhoid.
If a strain is resistant to a certain kind of antibiotic, taking that antibiotic will not kill the bacteria, and the bacteria will continue to grow.
Due to rising levels of antibiotic resistance, healthcare professionals may order tests to identify the strain of bacteria causing typhoid. This may influence the type of antibiotics prescribed.
It’s important to take all prescribed antibiotics as directed, even if you feel better. A stool culture can determine if you still carry S. typhi.
In some cases, people who have been treated for typhoid can still carry the bacteria. This is called being a “chronic carrier.“
A chronic carrier is often asymptomatic and can shed bacteria from typhoid in their urine or stools and, in some cases, from wounds or tissues.
Chronic carriers may continue to shed bacteria for more than a year after the onset of their acute initial illness with typhoid.
Without treatment, typhoid can lead to serious, life threatening complications. Worldwide, there are between
With treatment, most people start to improve within 3 to 5 days. Almost everyone who receives prompt treatment makes a full recovery.