Robert Wood Johnson University Hospital
 

Typhoid Fever

Typhoid Fever

What is typhoid fever?

Typhoid fever is a life-threatening bacterial infection caused by the bacterium Salmonella enterica serotype Typhi (S. typhi). According to the CDC, typhoid fever affects about 22 million people in the world each year. The incidence of typhoid fever in U.S. citizens and residents is low, with the majority of cases being acquired while traveling internationally.

How is typhoid fever spread?

S. typhi live only in humans, and are carried in the bloodstream and intestinal tracts of people who have typhoid fever. A small number of people recover from typhoid fever but continue to carry the bacteria.

Both the carriers and the people who have active typhoid fever shed S. typhi in their stools. Typhoid fever is spread by consuming food or beverages that have been handled by a person who is shedding S. typhi, or if sewage contaminated with S. typhi bacteria gets into water used for drinking or washing food.

What are the symptoms of typhoid fever?

When S. typhi bacteria are consumed, they multiply and spread into the bloodstream. Symptoms may not develop for six to 30 days after initial exposure.

The body reacts with signs and symptoms such as:

The symptoms of typhoid fever may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

How is typhoid fever diagnosed?

Typhoid fever can be diagnosed using a blood test or stool sample to determine the presence of S. typhi bacteria. However, the accuracy of these tests is variable, particulary during the acute phase of the disease. Subsequently, clinical signs and symptoms, as well as travel history, have to be considered when making the diagnosis. 

How can typhoid fever be prevented?

A vaccination for typhoid fever is available. However, it can lose effectiveness after several years, so a booster vaccination may be necessary.

Other preventive measures for travelers to high-risk areas include the following:

Taking antibiotics is not a preventive for typhoid fever.

Treatment for typhoid fever

See your doctor immediately if you think you have been exposed to typhoid fever. People who do not get treatment may continue to have fever for weeks or months, and may eventually die from complications. Treatment will probably include an antibiotic to treat the disease. Specific treatment for typhoid fever will be determined by your doctor based on:

It is important to remember that the danger of typhoid fever does not end when symptoms disappear. You could still be carrying S. typhi and the illness could return, or you could pass the disease to other people. People who have typhoid fever should:

Typhoid fever and the traveler

Typhoid fever is very common in developing countries. Travelers to Asia (except Japan), Africa, and Latin America are especially at risk. The CDC recommends avoiding risky food or drink and considering vaccination one to two weeks before traveling to an area where typhoid fever is common.

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