What is typhoid fever?

Typhoid fever is a life-threatening illness caused by the bacterium, Salmonella typhi. The illness causes:

• Sustained fever
• Headache
• Malaise
• Anorexia
• Relative bradycardia (slow heart rate)
• Constipation or diarrhea
• Nonproductive cough

Who gets typhoid fever?

Anyone can get typhoid fever if they drink water or eat food contaminated with the S. typhi bacterium.

In the United States, about 400 cases occur each year, and 70 percent of these are acquired while traveling internationally. Typhoid fever is still common in the developing world, where it affects about 12.5 million people each year.

How is typhoid fever spread?

You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding S. typhi in their stool, or if sewage contaminated with S. typhi bacteria gets into the water you use for drinking or washing food.

How soon after exposure do symptoms appear?

Symptoms can occur within three days up to three months after consumption of contaminated food or water, usually in one to three weeks.

How is typhoid fever diagnosed?

Typhoid fever is diagnosed by isolating S. typhi from blood or stool.

What is the treatment for typhoid fever?

Antibiotics are used to treat typhoid fever. People given antibiotics usually begin to feel better in 2 to 3 days, and deaths rarely occur. However, those who do not get treatment may continue to have fever for weeks or months, and as many as 20 percent may die from complications of the infection.

What is important to remember about typhoid fever is that, even if your symptoms go away, you may still be carrying S. typhi. If so, your illness could return, and you could pass the disease along to other people.

If you work at a job where you handle food or care for small children, you may be barred legally from going back to work until a doctor has determined that you no longer carry any typhoid bacteria.

If you are being treated for typhoid fever, it is important to do the following:

• Take the prescribed antibiotics for as long as the doctor has asked you to take them.
• Wash your hands carefully with soap and water after using the bathroom, and do not prepare or serve food for other people.
• Have your doctor obtain stool specimens for laboratory cultures to ensure that no S. typhi bacteria remain in your body.

How can typhoid fever be prevented?

If you are traveling to an area where typhoid fever is common you may want to be vaccinated against typhoid fever.

The following precautions are recommended:

• Water should be brought to a rolling boil for one minute before drinking it.
  • Bottled water may also be used (bottled carbonated water is safer than uncarbonated water).
  • Other safe beverages include tea and coffee made with boiled water and bottled beverages with no ice.
• Ask for drinks without ice unless the ice is made from bottled or boiled water.
  • Avoid popsicles or flavored ices that may have been made with contaminated water.
• Eat foods that have been thoroughly cooked and are still hot and steaming.
• Avoid raw vegetables and fruits that cannot be peeled.
• When you eat raw fruit or vegetables that can be peeled, peel them yourself
  • Wash your hands with soap first
  • Do not eat the peelings
• Avoid foods and beverages from street vendors.
  • It is difficult for food to be kept clean on the street, and many travelers get sick from food bought from street vendors.
• A simple rule of thumb is: “Boil it, cook it, peel it, or forget it!”

Both injectable and oral vaccines are available. Visit a doctor or travel clinic to discuss your vaccination options. Even if you are vaccinated, it is still important to be aware of what you are eating and drinking.

The vaccines are not 100 percent effective, and avoiding risky foods and drinks will also help protect you against other illnesses, including cholera, dysentery and hepatitis A.

Where can I get more information?

Contact your physician or the Southern Nevada Health District, Office of Epidemiology at (702) 759-1300.

The Division of Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention has information on typhoid fever and other diseases of concern to travelers at www.cdc.gov/travel/