Typhoid Fever

What is Typhoid Fever?

Typhoid fever (enteric fever) is a common health concern in developing countries, and children are particularly vulnerable. It is caused by Salmonella typhi bacteria, and it is spread via fecal matter to tainted food, beverages and water. Poor hygiene and food mishandling are largely to blame.

Visitors to developing countries should drink bottled water and avoid raw or undercooked foods including meat, fruits and vegetables. Food handling practices and preparation methods should be noted whenever possible. Hand washing is of the utmost importance before and after bathroom usage. Hand sanitizer should be applied often, especially when soap and water are unavailable.  A typhoid fever vaccination can provide protection, but it does not guarantee immunity.

What are the Symptoms of Typhoid Fever?

The symptoms of typhoid fever become increasingly worse when untreated. Signs of the illness can take up to three weeks to appear.

Symptoms include:

  • Gradually increasing fever that may reach 104.9 degrees F
  • Head pain
  • Lethargy
  • Sweating
  • Muscular weakness
  • Aching muscles
  • Unproductive cough
  • Decreased appetite
  • Weight loss
  • Stomach pain
  • Abdominal bloating
  • Loose stools
  • Constipation

Uncommon complications of typhoid fever may include:

Typhoid Fever Causes

Infectious bacteria known as Salmonella typhi (S. typhi) causes typhoid fever. This is a separate bacteria to the variety of S. typhi that causes salmonellosis, which is also a severe intestinal contamination. There are two ways typhoid fever can be caused, through fecal-oral transmission and by typhoid carriers.

Fecal-oral transmission

Typhoid fever spreads through contaminated water or food and the bacteria can occasionally come into direct contact with others nearby. In places where typhoid fever is endemic, the disease typically spreads from poor hygiene and drinking contaminated water. In countries that are more industrialized, typhoid bacteria is typically picked up while traveling and is then spread to others in a fecal-oral manner.

S. typhi is passed via feces, and can also be spread by the urine of those who are infected. The infection can be contracted when a person who has typhoid fever handles food and has not cautiously sanitized their hands. Drinking water can also contain the bacteria.

Typhoid carriers

The bacteria can still affect individuals who have recovered from typhoid fever as it can stay in the gallbladder or intestinal tract for years, even after antibiotic treatment. These individuals are chronic carriers and can contaminate others even though they may not have any symptoms or signs of typhoid fever themselves.

How is Typhoid Fever Treated?

The only curative treatment for typhoid fever is antibiotic medication. However, Salmonella typhi is resistant to many antibiotics. The most commonly prescribed type for adults is Ciprofloxacin. Children, pregnant women and others who cannot have Ciprofloxacin may be given an injection of Ceftriaxone.

Other treatments for typhoid fever may include:

  • Fluids to combat dehydration
  • Surgical repair of intestinal damage

When left untreated typhoid fever can cause internal bleeding, intestinal perforation and death. When typhoid fever is suspected, it is important to see a doctor that specializes in infectious diseases as soon as possible.

Typhoid Fever Prevention

Public health goals typically control and prevent typhoid fever for most developing countries. For other countries, it can be hard to achieve improved sanitation, appropriate medical care, and nontoxic drinking water. Due to the difficulty involved with controlling the disease, certain experts recommend vaccinations for populations that are high-risk.

It is recommended to receive a vaccine if you are visiting higher risk areas for typhoid fever. However, the vaccine will necessitate repeat immunizations due to its tendency to become less effective after time passes.

The following guidelines are recommended for those who are traveling to areas in which there is a high risk of contracting typhoid fever.

Guidelines to follow for prevention:

  • Careful hand washing
  • Do not drink water that is untreated (this includes ice and tap water)
  • Raw vegetables and fruits should be avoided as they have likely been washed in water that is unsafe
  • Select hot foods

Those who are recuperating from typhoid fever can take the following actions to maintain the safety of others as much as possible. Take your antibiotics, avoid the handling of food, and wash your hands often to help prevent the spread of infection.

Last Reviewed:
October 11, 2016
Last Updated:
September 10, 2017