Typhoid Fever

Last Reviewed: November 2011

What is typhoid fever?

Typhoid fever is a bacterial infection of the intestinal tract and occasionally the bloodstream. It is an uncommon disease with only a handful of cases occurring in New York each year. Most of the cases are acquired during foreign travel to underdeveloped countries. Typhoid fever is caused by Salmonella Typhi (S. Typhi), a strain of bacteria that lives only in humans.

Who gets typhoid fever?

Anyone can get typhoid fever but the greatest risk exists to travelers visiting countries where the disease is common. Occasionally, local cases can be traced to exposure to a person who is a chronic carrier. Outbreaks are rare.

How is the germ spread?

Typhoid germs are passed in the feces and, to some extent, the urine of infected people. The germs are spread by eating or drinking water or foods contaminated by feces from the infected individual.

What are the symptoms?

Symptoms may be mild or severe and may include fever, headache, constipation or diarrhea, rose-colored spots on the trunk and an enlarged spleen and liver. Relapses are common. Fatalities are less than 1 percent with antibiotic treatment.

How soon do symptoms appear?

Symptoms generally appear one to three weeks after exposure.

For how long can an infected person carry the typhoid germ?

About 5 percent of people infected with S. Typhi become lifelong carriers, releasing the germ in their stool for years, which can spread the disease.

How is typhoid treated?

Specific antibiotics such as ampicillin, trimethoprim-sulfamethoxazole and ciprofloxacin are often used to treat cases of typhoid.

Should infected people be isolated?

Because the germ is passed in the feces of infected people, only people with active diarrhea who are unable to control their bowel habits (infants, certain handicapped individuals) should be isolated. Most infected people may return to work or school when they have recovered, provided that they carefully wash hands after toilet visits. Children in daycare and health care workers must obtain the approval of the local or state health department before returning to their routine activities. Food handlers may not return to work until three consecutive negative stool cultures are confirmed.

Is there a vaccine for typhoid?

Yes. A vaccine is available for people traveling to underdeveloped countries where significant exposure may occur. As important, pay strict attention to food and water precautions while traveling to countries where typhoid is common. For more information about vaccination, speak to your health care provider.