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.

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

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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.