• Typhoid Fever

    (Enteric Fever; Paratyphoid Fever)


    Typhoid fever and paratyphoid fever are serious illnesses. It occurs most often in developing countries where sanitation is poor. Typhoid fever is rare in the United States. These fevers can be fatal, especially when not treated.


    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
    The bacteria infects the intestine. From the intestine it can enter the bloodstream and move to other organs.
    Digestive System
    Small intestines
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    Risk Factors

    Factors that increase your risk of typhoid fever 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 may include:
    • Fever, often over a long period of 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


    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.


    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 passed. People who are chronic carriers can shed the contagious bacteria in their stool or urine. This condition can be treated with antibiotics or, in unusual cases, surgery.
    Your doctor may also recommend medication to help reduce the fever. In general, rest and drink plenty of fluids.


    There are two main ways to prevent typhoid fever:
      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. Ensure that they are thoroughly cooked.
      • Avoid any raw fruits and vegetables that cannot be peeled.
      • Avoid raw shellfish.
      • Avoid unpasteurized dairy products.
      Vaccination — recommended if you are planning to visit a country where typhoid fever is prevalent.
      • Centers for Disease Control and Prevention (CDC) website has recommended vaccinations before traveling: http://wwwnc.cdc.gov/travel/destinations/list.htm
      • Be aware that the vaccine is not always effective. Careful food monitoring is still important.


    Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/

    World Health Organization (WHO) http://www.who.int/


    Public Health Agency of Canada http://www.phac-aspc.gc.ca/


    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.

    Typhoid fever. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid%5Ffever/ . Accessed December 28, 2012.

    Typhoid fever. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated September 14, 2012. Accessed December 28, 2012.

    Typhoid vaccine. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-typhoid.pdf . Accessed December 28, 2012.

    Revision Information

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