Typhoid Fever
En Español (Spanish Version)

Definition
Typhoid fever and paratyphoid fever are serious illnesses caused by Salmonella bacteria. It may be Salmonella typhi or Salmonella paratyphi . Typhoid fever is rare in the United States. It occurs most often in developing countries where sanitation is poor. Typhoid fever can be fatal, especially when not treated.

Causes
Typhoid fever is caused by eating foods or drinking beverages contaminated with the Salmonella bacteria. Contamination can occur from:
  • Food or drinks handled by someone who is sick or coming down with typhoid fever
  • Food or drinks handled by someone who has no symptoms but carries the bacteria
  • Sewage contamination of water or food
  • Unpasteurized dairy products
  • Poultry products left unrefrigerated

Once bacteria enter the body, they infect the intestine. Bacteria can be carried through the bloodstream to other organs.

Digestive System

© 2011 Nucleus Medical Media, Inc.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Risk factors include:
  • Drinking contaminated water
  • Eating raw shellfish
  • Eating fruits and vegetables that are raw or have been washed with contaminated water
  • Living in, or recent travel, to a country with poor sanitation

Symptoms
Symptoms may include:
  • Fever, often for a prolonged time
  • Chills
  • Severe headaches
  • Constipation or diarrhea
  • Abdominal pain
  • Fatigue or lethargy
  • Loss of appetite
  • Rose-colored spots on the body
  • Dizziness
  • Muscle pains
  • Swelling of the neck glands, liver, or spleen

Diagnosis
The doctor will ask about your symptoms and medical history. A physical exam will be done. Typhoid fever is usually diagnosed with a blood culture.

Treatment
Typhoid fever is treated with antibiotics.

Typhoid fever is very contagious until treated. In a small number of cases, people may become typhoid carriers even after the illness has subsided. People who are chronic carriers can shed contagious Salmonella bacteria in their stool or urine. This condition can be treated with antibiotics or, in unusual cases, surgery.

Prevention
There are two main ways to prevent typhoid fever:

Vaccine—A typhoid vaccine is recommended if you are planning to visit a country where typhoid fever is prevalent. However, the vaccine is not always effective and careful food monitoring is just as important. Visit the Centers for Disease Control and Prevention (CDC) website to find out if you should be vaccinated before traveling: http://wwwnc.cdc.gov/travel/destinations/list.htm.

Careful food monitoring—When you are in an area where typhoid fever is prevalent, always take the following precautions:
  • Drink only bottled water or water that has been boiled for at least one minute. This includes ice.
  • Eat foods while they are still hot, and ensure that they are thoroughly cooked.
  • Avoid any raw fruits and vegetables that cannot be peeled.
  • Avoid raw shellfish.
  • Avoid unpasteurized dairy products.




RESOURCES:
Centers for Disease Control and Prevention (CDC)

World Health Organization (WHO)

CANADIAN RESOURCES:
Public Health Agency of Canada

References:
Bhan MK, Bahl R, Bhatnagar S. Typhoid and paratyphoid fever. Lancet . 2005 Aug 27-Sep 2;366(9487):749-62.

Bui YG, Trépanier S, Milord F, Blackburn M, Provost S, Gagnon S. Cases of Malaria, Hepatitis A, and Typhoid Fever Among VFRs, Quebec (Canada). J Travel Med. 2011;18(6):373-378.

Johnson KJ, Gallagher NM, Mintz ED, Newton AE, Brunette GW, Kozarsky PE. From the CDC: New Country-Specific Recommendations for Pre-Travel Typhoid Vaccination. J Travel Med. 2011;18(6):430-433.

Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/typhoidfever_g.htm#Getting%20vaccinated . Accessed November 18, 2009.

Last Reviewed November 2011