Typhoid Fever
Definition
Typhoid fever and paratyphoid fever are serious illnesses caused by Salmonella bacteria, either Salmonella typhi or Salmonella paratyphi , respectively. It occurs most often in developing countries where sanitation is poor. Typhoid fever can be fatal, especially when not treated.
Causes
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
Once bacteria enter the body, they infect the intestine. Bacteria can be carried through the bloodstream to other organs.
Digestive System

Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Risk factors 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
Symptoms may develop within 1 to 3 weeks after exposure. Symptoms may include:
- Fever, often for a prolonged 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
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. Typhoid fever is usually diagnosed with a blood culture.
Treatment
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 subsided. People who are chronic carriers can shed contagious Salmonella bacteria in their stool or urine. This condition can be treated with antibiotics or, in unusual cases, surgery.
Prevention
There are two main ways to prevent typhoid fever:
Vaccine—A typhoid vaccine is recommended if you are planning to visit a country where typhoid fever is prevalent. However, the vaccine is not always effective and careful food monitoring is just as important.
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, and ensure that they are thoroughly cooked.
- Avoid any raw fruits and vegetables that cannot be peeled.
- Avoid raw shellfish.
- Avoid unpasteurized dairy products.
RESOURCES:
Centers for Disease Control and Prevention (CDC)
http://www.cdc.gov
World Health Organization (WHO)
http://www.who.int
CANADIAN RESOURCES:
BC HealthGuide
http://www.bchealthguide.org
Public Health Agency of Canada
http://www.phac-aspc.gc.ca
References:
Bhan MK, Bahl R, Bhatnagar S. Typhoid and paratyphoid fever. Lancet . 2005 Aug 27-Sep 2;366(9487):749-62.
Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov . Accessed October 12, 2005.
Last reviewed November 2008 by David L. Horn, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.