Typhoid fever is caused by Salmonella typhi bacteria. Typhoid fever is rare in industrialized countries. However, it remains a serious health threat in the developing world. Typhoid fever spreads through contaminated food and water or through close contact with someone who's infected. Signs and symptoms usually include high fever, headache, abdominal pain, and either constipation or diarrhea.
When treated with antibiotics, most people with typhoid fever feel better within a few days, although a small percentage may die of complications.
Vaccines against typhoid fever are available, but they're only partially effective. Vaccines are usually reserved for those who may be exposed to the disease or are traveling to areas where typhoid fever is common.
Although children with typhoid fever sometimes become sick suddenly, signs and symptoms are more likely to develop gradually — often appearing one to three weeks after exposure to the disease.
First week of illness
Children are more likely to have diarrhea, whereas adults may become severely constipated. During the second week, you may develop a rash of small, flat, rose-colored spots on your lower chest or upper abdomen. The rash is temporary, usually disappearing in two to five days.
Second week of illness
Third week of illness
Life-threatening complications often develop at this time.
Fourth week of illness
When to see a doctor
If you develop signs and symptoms after you return home, consider consulting a doctor who focuses on international travel medicine or infectious diseases. A specialist may be able to recognize and treat your illness more quickly than can a doctor who isn't trained in these areas.
Typhoid fever is caused by a virulent bacterium called Salmonella typhi. Although they're related, this isn't the same as the bacteria responsible for salmonellosis, another serious intestinal infection.
This means that S. typhi is passed in the feces and sometimes in the urine of infected people. You can contract the infection if you eat food handled by someone with typhoid fever who hasn't washed carefully after using the bathroom. You can also become infected by drinking water contaminated with the bacteria.
Typhoid fever remains a serious worldwide threat — especially in the developing world — affecting more than 21 million people each year, according to the Centers for Disease Control and Prevention. The disease is endemic in India, Southeast Asia, Africa, South America and many other areas.
Worldwide, children are at greatest risk of getting the disease, although they generally have milder symptoms than adults do.
If you live in a country where typhoid fever is rare, you're at increased risk if you:
Intestinal bleeding or perforation
Intestinal bleeding is often marked by a sudden drop in blood pressure and shock, followed by the appearance of blood in your stool.
A perforated intestine occurs when your small intestine or large bowel develops a hole, causing intestinal contents to leak into your abdominal cavity and triggering signs and symptoms such as severe abdominal pain, nausea, vomiting and bloodstream infection (sepsis). This life-threatening emergency requires immediate medical care.
Other, less common complications
With prompt treatment, nearly all people in industrialized nations recover from typhoid. Without treatment, some people may not survive complications of the disease.
Preparing for your appointment
Call your doctor if you've recently returned from travel abroad and develop mild symptoms similar to those that occur with typhoid fever. If your symptoms are severe, go to an emergency room or call 911 or your local emergency number.
Here's some information to help you get ready, and what to expect from your doctor.
Information to gather in advance
For typhoid fever, possible questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment if you don't understand something.
What to expect from your doctor
Tests and diagnosis
Medical and travel history
Body fluid or tissue culture
Although performing a culture test is the mainstay for diagnosis, in some instances other testing may be used to confirm a suspected typhoid infection, such as a test to detect antibodies to typhoid bacteria in your blood or a test that checks for typhoid DNA in a blood sample.
Treatments and drugs
Antibiotic therapy is the only effective treatment for typhoid fever.
Commonly prescribed antibiotics
Problems with antibiotic resistance
In many developing nations, the public health goals that can help prevent and control typhoid — safe drinking water, improved sanitation and adequate medical care — may be difficult to achieve. For that reason, some experts believe that vaccinating high-risk populations is the best way to control typhoid fever.
Two vaccines are currently in use — one is injected in a single dose, and the other is given orally over a period of days. Neither vaccine is 100 percent effective, and both require repeat immunizations as vaccine effectiveness diminishes over time.
If you're traveling to an area where typhoid fever is endemic, consider being vaccinated. But because the vaccine won't provide complete protection, be sure to follow these guidelines as well:
To prevent infecting others
Last Updated: 2010-04-09
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