Typhoid Fever

Reviewed: September 2017

What is typhoid fever?

Typhoid fever is a bacterial infection of the intestinal tract (bowels/gut) and occasionally the bloodstream caused by the Salmonella Typhi bacteria. This strain of bacteria lives only in humans. 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 developing countries.

Who gets typhoid fever?

Anyone can get typhoid fever but travelers visiting developing countries where the disease is common are at the greatest risk. Occasionally, local cases can occur from exposure to a person who previously recovered from typhoid but still carries the bacteria and sheds it in their feces (poop).

How is typhoid fever­­­ spread?

Salmonella Typhi lives only in humans. People with typhoid fever carry the bacteria in their bloodstream and intestinal tract (bowels/gut). In addition, a small number of people, called carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed Salmonella Typhi in their feces (poop).

You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding Salmonella Typhi or if sewage contaminated with Salmonella Typhi bacteria gets into the water you use for drinking or washing food. Therefore, typhoid fever is more common in areas of the world where handwashing is less frequent and water is more likely to be contaminated with sewage.

What are the symptoms of typhoid and when do they appear?

Symptoms may be mild or severe and may include fever, headache, constipation or diarrhea (loose stool/poop), rose-colored spots on the trunk of the body, and an enlarged spleen and liver. It is common for symptoms to go away and then appear again. Death occurs in less than 1 percent of those who get antibiotic treatment. Symptoms generally appear one to two weeks after exposure to the bacteria.

How is typhoid diagnosed?

Symptoms may cause a health care provider to suspect typhoid fever, but a stool or blood test, which tests for the presence of the bacteria, is the only way to diagnose it.

How is typhoid treated?

Typhoid fever is treated with antibiotics. Resistance to multiple antibiotics is increasing among the Salmonella bacteria that cause typhoid fever, complicating treatment of infections. People who do not get treatment may continue to have fever for weeks or months, and as many as 20% may die from complications of the infection.

Should infected people stay out of school/work?

Most infected people may return to work or school when they have recovered, if they carefully wash hands after using the toilet. 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.

Does past infection with typhoid make a person immune?

People can be reinfected if they come into contact with the bacteria again.

What can be done to prevent the spread of typhoid?

A vaccine is available for people traveling to developing countries where significant exposure may occur. For more information about vaccination, speak to your health care provider. It is equally important to pay strict attention to food and water precautions while traveling to countries where typhoid is common. When drinking water in a developing country, you should buy it in a sealed bottle, boil it, or chemically treat it. When eating foods, avoid raw fruits and vegetables that cannot be peeled and washed, undercooked foods, and foods from street vendors. Additionally, food handlers may not work while sick with typhoid.