What Is Typhoid Fever?

Typhoid fever is a serious and sometimes life-threatening infection. It mostly affects people in developing countries, where sanitation is poor and getting clean water is a problem.

Typhoid is rare in the U.S. But if you plan to travel to a foreign country (especially South-central and Southeast Asia, Africa, Latin America, or the Caribbean), it's a good idea to talk to your doctor about prevention and treatment of typhoid fever.

What Causes Typhoid Fever?

Typhoid fever is caused by bacteria called Salmonella typhi (S. typhi), which are related to the salmonella bacteria that cause food poisoning. They typically live in humans and are shed through a person's feces (poop) or urine (pee).

The infection happens when a person eats or drinks something contaminated with the bacteria. When the bacteria get into the body, they quickly multiply and spread into the bloodstream.

People usually get typhoid fever by drinking beverages or eating food that has been handled by someone who has typhoid fever or is a carrier of the illness. Those infected also can pass the disease to others directly (for example, by touching them with unwashed hands). People also get the illness by drinking water that is contaminated by sewage.

What Are the Signs & Symptoms of Typhoid Fever?

Typhoid fever can come on suddenly or very gradually over a few weeks. The disease usually causes a high fever, a stomachache, and achiness a week or two after exposure to the bacteria (but sometimes later).

If the infection isn't treated, a person may lose weight; develop a swollen or bloated belly; or develop a red, spotted rash on the lower chest or upper belly. Without treatment, typhoid fever may last a month or more and become very serious, even life-threatening.

In most cases, the symptoms start to go away in the third and fourth weeks, as long as the disease doesn't cause any other health problems. Sometimes, after the illness seems gone it can come back.

After recovering from typhoid fever, some people become carriers of the bacteria. This means that they'll have no symptoms, but do have the bacteria in their bodies and can pass it on to others.

How Is Typhoid Fever Diagnosed?

To diagnose typhoid fever, doctors check a person's symptoms and ask about their medical history and recent travels. They usually take a sample of stool (poop), urine (pee), or blood and test it for the disease.

How Is Typhoid Fever Treated?

Typhoid fever is treated with antibiotics that kill the bacteria. It's important for people with typhoid fever to take the medicine for the whole time that the doctor prescribes, even if they feel better. Stopping too soon means some bacteria could remain.

Most people start feeling better within 2–3 days of starting treatment. They should drink plenty of fluids to prevent dehydration. Someone who gets severely dehydrated due to diarrhea might need to get IV (intravenous) fluids in a hospital or other medical care facility.

If your child has typhoid, acetaminophen can help reduce fever and make them feel more comfortable. Call a doctor right away if your child's symptoms last, if they go away and come back, or if your child has any new symptoms.

People with typhoid fever should stay home until the disease has run its course and a doctor makes sure that the bacteria are gone. Those who work in the food service industry may not legally be allowed to return to work until a doctor has proved they are free of the bacteria.

Can Typhoid Fever Be Prevented?

Two typhoid vaccines are available in the U.S. One is a series of capsules and the other is an injection. In some cases, a booster is needed.

The typhoid vaccine is not a routine childhood vaccination. If your child will travel to an area where typhoid fever is common, you'll need to ask your doctor for the vaccine. Kids should be vaccinated at least 1 to 2 weeks before travel. This gives the vaccine time to take effect. Your doctor will have the most current information and recommendations.

What Else Should I Know?

Even if everyone in your family has been vaccinated, vaccines are not completely effective and lose effectiveness over time. So take these precautions in high-risk areas:

• Sanitize water. Boil or disinfect any water that will be used for drinking, washing or preparing food, making ice, or brushing teeth. Better yet, try to drink only bottled water (carbonated is safer than regular) or other drinks that come in cans or bottles, but wipe the outside of the can or bottle before drinking from it. Tell kids to avoid tap water, fountain drinks, and ice cubes, and remind them to not swallow any water in the shower or bath.
• Cook all food. Fully cook all food, and avoid food from street vendors and food stored or served at room temperature. Instead, serve packaged foods or meals that are freshly cooked and served steaming hot.
• Avoid raw food. Avoid raw, unpeeled fruits and vegetables that may have been washed with contaminated water, especially lettuce and fruits like berries that can't be peeled. Bananas, avocados, and oranges make better choices, but be sure you peel them yourself. For safety's sake, you may want your kids to avoid raw foods entirely.
• Wash hands well and often. Wash with soap and clean, warm water, especially after kids use the bathroom or before they eat or prepare food. If no soap and water are available, use an alcohol-based hand sanitizer.