Typhoid fever is an illness you get from S. Typhi bacterium. It causes a high fever, flu-like symptoms and diarrhea. You can be contagious with typhoid even if you don’t feel sick. Typhoid can be life threatening and should be treated promptly with antibiotics. If you live in or travel to an area where typhoid is common, you should get vaccinated.
What is typhoid fever?
Typhoid fever is an illness caused by the bacterium Salmonella Typhi (S. Typhi). It infects your small intestines (gut) and cause high fever, stomach pain and other symptom. Typhoid fever is also called enteric fever.
You’ll commonly hear paratyphoid fever mentioned along with typhoid. Paratyphoid fever is similar to typhoid with more mild symptoms. It’s caused by Salmonella Paratyphi (S. Paratyphi).S. Typhi and S. Paratyphi are different than the Salmonella bacteria that cause salmonellosis, a common type of food poisoning
Who does typhoid fever affect?
The majority of typhoid fever cases occur in underdeveloped nations’ rural areas, where there is no access to modern sanitation. Typhoid mostly affects countries in Africa, the Caribbean, Central and South America, and South and Southeast Asia. The countries where tourists are most vulnerable include Bangladesh, India, and Pakistan.
Typhoid fever is more common in children than in adults.
How common is typhoid fever?
It’s estimated that 11 million to 21 million people around the world get typhoid each year. It’s rare in the U.S., Canada, Japan, Western Europe and Australia.
What’s a long-term carrier of typhoid fever?
Even after recovering from typhoid fever, some people (known as long-term carriers) still have the disease. Typhoid fever can spread for a year or more in the absence of symptoms. After you feel better, it’s crucial to get tested for S. Typhi to make sure you can’t infect anybody else.
What’s the difference between typhoid and typhus?
While the names sound the same, typhoid and typhus are different illnesses, caused by different bacteria. The symptoms are similar — so much so that doctors used to think they were the same illness. We now know they’re different illnesses, but the similar name stuck (and so did the confusion it causes).
What are the symptoms of typhoid fever?
Typhoid fever gets its name from a high fever that can last for weeks if left untreated. It often gets progressively worse over a few days.
Other symptoms of typhoid fever include:
- Headache.
- Chills.
- Loss of appetite.
- Stomach (abdominal) pain.
- “Rose spots” rash, or faint pink spots, usually on your chest or stomach.
- Cough.
- Muscle aches.
- Nausea, vomiting.
- Diarrhea or constipation.
What causes typhoid fever?
Typhoid fever is caused by the bacterium S. Typhi. It lives in the gut (intestines) of infected people and can contaminate food and water.
How does typhoid fever spread?
The typical way that typhoid fever spreads is through tainted food or water (S. Typhi). If someone who has typhoid touches anything you eat or drink without washing their hands, this might occur. Additionally, it might occur if waste water—that is, water containing feces or poop—gets into your food or drink.
Someone else may infect you with typhoid if they don’t wash their hands after using the restroom. They can leave behind germs on surfaces and things (like phones or doorknobs) that can be contacted by someone else.
Does typhoid spread by kissing?
No, typhoid doesn’t spread by kissing. You usually don’t get typhoid fever directly from another person. But you can get it if you touch something they’ve touched if they don’t wash their hands after going to the bathroom.
What are the stages of typhoid fever?
You can develop symptoms of typhoid fever gradually in four stages. Early treatment with antibiotics can keep you from progressing to later stages.
- Stage 1. You can start getting typhoid symptoms anywhere from five to 14 days after coming in contact with S. Typhi. The first symptom is a fever that gets higher over a few days — called “stepwise” since it goes up in steps. The bacteria is moving into your blood in this stage.
- Stage 2. Around the second week of fever, the bacteria is multiplying in your Peyer’s patches (part of your immune system that identifies harmful invaders). You’ll start experiencing abdominal pain and other stomach symptoms, like diarrhea or constipation. You might get “rose spots,” small pink dots on your skin that look like a rash.
- Stage 3. If not treated with antibiotics, the bacteria can cause severe damage, usually around the third week after your symptoms start. Some people get serious complications, like internal bleeding and encephalitis (inflammation in your brain).
- Stage 4. Stage four is when most people begin to recover. Your high fever begins to come down. S. Typhi can live in your gallbladder without causing symptoms, which means you may still be contagious even after you feel better.
Diagnosis and Tests
How is typhoid fever diagnosed?
Typhoid fever will be diagnosed by your healthcare professional based on your symptoms, travel history, and results from laboratory testing. Along with a physical examination, they will listen to your heart and lungs.
It’s critical that you inform your healthcare practitioner of any recent trip or suspected exposure to typhoid, since they may not know to test for it. Additionally, they will utilize the data to determine the course of treatment.
What tests can be done to diagnose typhoid fever?
Your healthcare provider will take samples of body fluids or tissue to test for signs of S. Typhi. They might take samples of your:
- Blood. Your provider will use a needle to take a small tube of blood from your arm.
- Poop (stool). Your healthcare provider will give you a sterile container and instructions on how to collect a sample.
- Pee (urine). You may be asked to pee into a cup given to you by your healthcare provider.
- Your provider might numb your skin and take a sample with a small razor or scalpel.
Bone marrow. Your provider will numb your skin and use a special needle to get a sample of the inside of your bones. It’s rare that you’d ever need this test for diagnosis
Management and Treatment.
What is the treatment for typhoid fever?
Antibiotics are used to treat typhoid. Depending on the type of typhoid you have and where you were ill, you may receive various antibiotic treatments since some of the more recent strains of the bacteria are resistant to them. Antibiotics are also used to treat parapyphoid fever.
You may require more treatments if you have issues or are really sick. For these therapies, you’ll most likely need to be hospitalized to the hospital.
What medications are used to treat typhoid fever?
Your healthcare provider will treat typhoid fever with antibiotics, which may include:
- Ciprofloxacin, levoflaxin or ofloxacin.
- Ceftriaxone, cefotaxime or cefixime.
- Azithromycin.
- Carbapenems
If your case is severe, you may be treated with steroids, like dexamethasone.
Antibiotic resistance in typhoid
Bacteria like S. Typhi can sometimes develop resistance to medications. This means that antibiotics don’t work to destroy them anymore (antibiotic resistance).
Many cases of typhoid can’t be destroyed by antibiotics we once used, but some drugs still work on them. Some are extremely drug resistant (XDR typhoid) and only a few antibiotics still work on them. This is one of the reasons that getting vaccinated to prevent typhoid is so important.
Health officials are concerned that we may no longer be able to treat typhoid if available medicines stop working. You’ll be treated with an antibiotic that works on the kind of typhoid you have based on the results of strain testing.
How do I take care of myself with typhoid fever?
Make sure you finish all of your medications as directed by your doctor in order to take care of yourself. Find out from your doctor whether taking non-steroidal anti-inflammatory medicines (NSAIDS) for pain or fever is safe if you use ibuprofen (Advil® or Motrin®), naproxen sodium (Aleve®), or acetaminophen (Tylenol®).
How soon after treatment for typhoid fever will I feel better?
If you’re treated early with an antibiotic, you should start to feel better in a few days. It might take a week to 10 days to feel completely recovered.
