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Typhoid Fever

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Monthly Observance

(Enteric Fever; Paratyphoid Fever)

Definition

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.

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

The bacteria infects the intestine. From the intestine it can enter the bloodstream and move to other organs.

Digestive System

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

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

Diagnosis

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.

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 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.

Prevention

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.

RESOURCES

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

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

CANADIAN RESOURCES

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.

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

Reviewer: Michael Woods, MD
Review Date: 11/2012 -
Update Date: 11/26/2012 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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