Typhoid Fever

Typhoid fever is a life-threatening illness caused by the germ (bacteria) Salmonella typhi.


Infection occurs after eating food or drinking water that is contaminated with human feces from an infected person. The infected person might have been ill with the infection, recovering from the infection, or be a chronic carrier of the bacteria. About 5% of infected people become chronic carriers. A chronic carrier continues to excrete the bacteria for more than 1 year. In countries that have large epidemics of typhoid, the problem is most often related to fecal contamination of water supplies or street vender food.


  • High fever. This comes and goes at first. It becomes constant after a few days of illness.

  • Headache.

  • Stomach cramps with diarrhea or constipation.

Less common symptoms include:

  • Nausea.

  • Vomiting.

  • Cough.

  • Rash.


Diagnosis is based on your history of travel, symptoms, and exam. Your caregiver may find that you have a fever, abdominal tenderness, and sometimes an enlarged liver or spleen. The only sure way to confirm that you have typhoid fever is by having samples of stool or blood tested for the presence of the bacteria.


A number of oral medicines that kill germs (antibiotics) are available that effectively treat this infection. People who are very sick can be treated with antibiotics given in the vein (intravenously).


You can get a vaccination against typhoid fever before you travel to a country where typhoid is common. Visit a caregiver or a travel clinic to discuss your vaccination options. Remember that you will need to complete your vaccination at least 1 to 2 weeks before you travel so that the vaccine has time to take effect.

The other very important way to prevent typhoid fever is to avoid risky foods and drinks.

  • Only drink bottled drinks and bottled water.

  • Ask for drinks without ice unless the ice is made from bottled or boiled water.

  • Avoid raw vegetables and fruits that cannot be peeled.

  • Avoid foods and beverages from street vendors. It is difficult for food to be kept clean on the street. Many travelers get sick from food bought from street vendors.

  • Remember to "Boil it, cook it, peel it, or forget it."


  • Follow all your caregiver's instructions.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Do not prepare food for others until you have been well and free of all symptoms for at least 1 week.


  • Your symptoms seem to be getting worse rather than better or new symptoms occur.

  • You have a fever.

  • Your fever gets worse or recurs.

  • You have questions or concerns.