Learn more about the symptoms, cause and treatment of this serious intestinal illness.
Typhoid fever is caused by Salmonella typhi bacteria. Typhoid fever is rare in developed countries. It is still a serious health threat in the developing world, especially for children.
Contaminated food and water or close contact with an infected person cause typhoid fever. Signs and symptoms usually include:
Most people who have typhoid fever feel better a few days after they start antibiotic treatment, but a small number of them may die of complications. Vaccines against typhoid fever are only partially effective. Vaccines usually are reserved for those who may be exposed to the disease or who are traveling to areas where typhoid fever is common.
Signs and symptoms are likely to develop gradually — often appearing one to three weeks after exposure to the disease.
Signs and symptoms include:
Without treatment, you may:
Life-threatening complications often develop at this time.
In some people, signs and symptoms may return up to two weeks after the fever has subsided.
See a doctor immediately if you think you might have typhoid fever. If you live in the United States and become sick while traveling in a foreign country, call the U.S. Consulate for a list of doctors.
If you have signs and symptoms after you return home, consider seeing a doctor who focuses on international travel medicine or infectious diseases. A doctor who is familiar with these areas may be able to recognize and treat your illness more quickly.
Typhoid fever is caused by dangerous bacteria called Salmonella typhi. Salmonella typhi is related to the bacteria that cause salmonellosis, another serious intestinal infection, but they aren't the same.
Most people in developed countries pick up typhoid bacteria while they're traveling. Once they have been infected, they can spread it to others through the fecal-oral route.
This means that Salmonella typhi is passed in the feces and sometimes in the urine of infected people. If you eat food that has been handled by someone who has typhoid fever and who hasn't washed carefully after using the toilet, you can become infected.
In developing countries, where typhoid fever is established, most people become infected by drinking contaminated water. The bacteria may also spread through contaminated food and through direct contact with someone who is infected.
Even after antibiotic treatment, a small number of people who recover from typhoid fever continue to harbor the bacteria. These people, known as chronic carriers, no longer have signs or symptoms of the disease themselves. However, they still shed the bacteria in their feces and are capable of infecting others.
Typhoid fever is a serious worldwide threat and affects about 27 million or more people each year. The disease is established in India, Southeast Asia, Africa, South America and many other areas.
Worldwide, children are at greatest risk of getting the disease, although they generally have milder symptoms than adults do.
If you live in a country where typhoid fever is rare, you're at increased risk if you:
Intestinal bleeding or holes in the intestine are the most serious complications of typhoid fever. They usually develop in the third week of illness. In this condition, the small intestine or large bowel develops a hole. Contents from the intestine leak into the stomach and can cause severe stomach pain, nausea, vomiting and bloodstream infection (sepsis). This life-threatening complication requires immediate medical care.
Other possible complications include:
With quick treatment, nearly all people in industrialized nations recover from typhoid fever. Without treatment, some people may not survive complications of the disease.
Safe drinking water, improved sanitation and adequate medical care can help prevent and control typhoid fever. Unfortunately, in many developing nations, these may be difficult to achieve. For this reason, some experts believe that vaccines are the best way to control typhoid fever.
A vaccine is recommended if you live in or are traveling to areas where the risk of getting typhoid fever is high.
Two vaccines are available.
Neither vaccine is 100% effective. Both require repeat immunizations because their effectiveness wears off over time.
Because the vaccine won't provide complete protection, follow these guidelines when traveling to high-risk areas:
Avoid drinking untreated water. Contaminated drinking water is a particular problem in areas where typhoid fever is endemic. For that reason, drink only bottled water or canned or bottled carbonated beverages, wine and beer. Carbonated bottled water is safer than non-carbonated bottled water.
Ask for drinks without ice. Use bottled water to brush your teeth, and try not to swallow water in the shower.
If you're recovering from typhoid fever, these measures can help keep others safe:
Your doctor is likely to suspect typhoid fever based on your symptoms and your medical and travel history. The diagnosis is usually confirmed by identifying Salmonella typhi in a culture of your blood or other body fluid or tissue.
For the culture, a small sample of your blood, stool, urine or bone marrow is placed on a special medium that encourages the growth of bacteria. The culture is checked under a microscope for the presence of typhoid bacteria. A bone marrow culture often is the most sensitive test for Salmonella typhi.
Although performing a culture test is the most common diagnostic test, other testing may be used to confirm a suspected typhoid fever infection, such as a test to detect antibodies to typhoid bacteria in your blood, or a test that checks for typhoid DNA in your blood.
Antibiotic therapy is the only effective treatment for typhoid fever.
Commonly prescribed antibiotics include:
These drugs can cause side effects, and long-term use can lead to the development of antibiotic-resistant bacteria.
In the past, the drug of choice was chloramphenicol. Doctors no longer commonly use it because of side effects, a high rate of health deterioration after a period of improvement (relapse) and widespread bacterial resistance.
In fact, antibiotic-resistant bacteria are becoming more common, especially in the developing world. In recent years, Salmonella typhi has also proved resistant to trimethoprim-sulfamethoxazole, ampicillin and ciprofloxacin.
Other treatments include:
Call your doctor if you've recently returned from travel abroad and develop mild symptoms similar to those that occur with typhoid fever. If your symptoms are severe, go to an emergency room or call 911 or your local emergency number.
Here's some information to help you get ready and know what to expect from your doctor.
For typhoid fever, possible questions to ask your doctor include:
Don't hesitate to ask any other related questions you have.
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:
December 22nd, 2020