Typhoid Fever

• Typhoid fever is caused by a bacteria called Salmonella typhi
• Typhoid fever transmission can happen through feces or urine
• Typhoid vaccine can provide some protection against typhoid fever and its complications

Typhoid fever is a contagious infection caused by bacteria. It is very common in parts of the world where people lack access to clean water and proper sanitation. These areas include Africa, Southeast Asia, India, and South America. People living in or traveling to these parts of the world should be cautious of this condition. In this guide by Ada’s medical team, you’ll be able to find more information on typhoid fever, its causes, symptoms, and treatment options. 

Typhoid fever, also known as enteric fever, is a bacterial infection of the gut that can severely affect multiple organs and can potentially be life-threatening. Typhoid fever is quite common, as there are 9 million people affected by the disease on a yearly basis. 1 2

Enteric fever is caused by a bacteria called Salmonella typhi and Salmonella paratyphi. These bacteria are most commonly spread through contaminated food and water. People living in overcrowded areas with poor sanitation are more at risk of infection. 3

The 4 stages of typhoid fever can be used to indicate the progression of the condition. The following stages can be distinguished: 2

1. Stage 1 typhoid fever: the bacteria that causes typhoid fever is moving into your bloodstream and is causing the first symptoms of typhoid (such as high fever, headache, and general aches).
2. Stage 2 typhoid fever: the bacteria that is causing typhoid starts to multiply in your body and causes additional symptoms of typhoid fever and a typical typhoid fever rash. 
3. Stage 3 typhoid fever: you can start to develop serious complications at this stage if your typhoid fever isn’t being treated
4. Stage 4 typhoid fever: in this stage, you’ll start to recover and your typhoid fever symptoms will slowly decrease. 

Typhoid fever symptoms can start to develop after an incubation period of 6 to 30 days. The incubation period refers to the time between the moment you come into contact with the bacteria and the development of the first symptoms. The most common symptoms of typhoid fever are: 2 3

• Fever that gradually gets worse
• Fatigue
• Lack of appetite
• Headache
• Feeling unwell generally
• Cough
• Diarrhea or constipation
• Abdominal pain
• A rash consisting of small pink dots

The symptoms of typhoid fever can get worse over time if the condition is not being treated appropriately. 

Typhoid fever can happen to anybody. Some people are more at risk, such as: 2 3

• Children and young adults
• People living in or traveling to countries with many cases of typhoid fever
• People with compromised immune systems
• People who eat undercooked foods

Typhoid fever is very contagious and is caused by a bacteria that can spread easily. If someone eats food or drinks beverages that have been contaminated with the bacteria, then they can fall ill as well. These bacteria can spread from an infected person to others through the feces, or less commonly through pee. Typhoid fever causes are often abbreviated as the 4F’s. This abbreviation stands for flies, fingers, feces, and fomites, and refers to the ways that the bacteria can spread to foods and drinks. 

In order to diagnose typhoid fever, your healthcare provider will ask you questions about the symptoms you’re experiencing and your medical history. If you’ve recently traveled to a country where typhoid fever occurs commonly and you have a fever, then your healthcare provider may suspect the condition. The next steps will be a series of laboratory tests. For these tests, some samples of your stool, blood, or urine will be collected. These samples are then analyzed under a microscope to check for the Salmonella bacteria. If the tests are inconclusive, a bone marrow sample may be needed to diagnose typhoid fever.

Once the diagnosis of typhoid fever is confirmed, other members of your household may also need to be tested as typhoid fever is very contagious, and early detection and treatment is essential. 

Typhoid fever treatments include antibiotics. The treatment strategy depends on how far the disease has progressed. Most cases of typhoid fever are mild in Europe and the U.S., and can usually be treated at home with a course of antibiotic tablets for 1 to 2 weeks. In more severe cases of typhoid fever, hospitalization may become necessary. In these cases, antibiotics will be administered through your bloodstream. Signs of recovery from typhoid fever are the symptoms fading away and your fever decreasing. 2 3

Typhoid fever supportive therapy can consist of rehydration, as your diarrhea may cause you to become dehydrated. 

The typhoid fever vaccine can help provide protection against typhoid fever. The typhoid vaccine is recommended for anyone living in or traveling to parts of the world where typhoid fever occurs frequently. This includes: 

• India
• Africa
• South and Southeast Asia
• South America 

The typhoid shot does provide some protection against typhoid fever, but it’s not a guarantee that you won’t fall ill. This means that it remains important to be cautious when traveling and to avoid foods and drinks that may be contaminated.

If you don’t get treated for typhoid fever or if the condition wasn’t caught early on, then you may develop complications that could potentially be fatal. Some potential complications of typhoid fever are: 4

• Meningitis
• Sepsis
• Perforation of your intestines
• Internal bleeding

These complications usually develop during the third week of the infection. These are serious complications that can lead to organ failure and death in some cases.

Typhoid fever is a bacterial infection that can be treated with antibiotics. If you don’t receive the correct treatment, then you may be at risk of severe complications such as meningitis, sepsis, intestinal perforation, and internal bleeding. These complications can even become fatal. The condition can be prevented by typhoid vaccination, practicing good hygiene, and being cautious when consuming foods and drinks in countries where typhoid fever occurs frequently.  

Q: How do you get typhoid fever? 
A: You can get typhoid fever by ingesting foods or drinks that have been contaminated with the Salmonella typhi or paratyphi bacteria. 

Q: Is typhoid fever contagious? 
A: Typhoid fever is very contagious. If you have typhoid fever, then you are contagious during the time that you experience symptoms, and for some time afterward as well, as the bacteria can stay present in the bowels for some time.

Q: What is one of the first signs of typhoid? 
A: One of the first signs of typhoid fever is a fever that gradually gets worse. Other symptoms may include stomach ache, diarrhea, constipation, a loss of appetite, and a rash. 

Q: What is the best cure for typhoid? 
A: The best cure for typhoid fever is antibiotics. Typhoid fever treatment should be initiated as soon as possible for a better outcome. 

Q: Can typhoid go away on its own? 
A: Typhoid fever can go away on its own, although without treatment, there is a significantly higher chance of developing complications that may become fatal. 

Q: What is the difference between typhus vs typhoid fever? 
A: Both typhus and typhoid fever are caused by bacteria. They are caused by different types of bacteria and are also different illnesses. 

Q: How long is typhoid vaccine good for? 
A: The typhoid vaccine should be administered about 1 month before traveling to a country where typhoid occurs frequently. If you continue to be at risk for typhoid fever, then you can get a booster vaccination every 3 years.