(Enteric Fever; Paratyphoid Fever)
Typhoid fever and paratyphoid fever are serious infectious illnesses. They occur most often in developing countries where sanitation is poor.
Typhoid fever is caused by eating foods or drinking beverages contaminated with specific bacteria. Contamination can be present in:
- Food or drinks handled by someone who is sick with typhoid fever
- Food or drinks handled by someone who has no symptoms, but carries the bacteria
- Water or food contaminated by sewage
- Unpasteurized dairy products
- Unrefrigerated poultry products
Factors that may increase your chance of typhoid fever include:
- Not drinking boiled or bottled water
- Eating raw shellfish
- Eating fruits and vegetables that are raw or have been washed with contaminated water
- Living in, or recent travel, to a country with poor sanitation
- Decreased stomach acid, usually from taking acid reducing medications
Symptoms may include:
The doctor will ask about your symptoms and medical history. A physical exam will be done. Typhoid fever is usually diagnosed with a blood culture.
Typhoid fever is treated with antibiotics.
Typhoid fever spreads easily until it is treated. In a small number of cases, people may become typhoid carriers even after the illness has passed. People who are chronic carriers can shed the contagious bacteria in their stool or urine. This condition can be treated with antibiotics or, in unusual cases, surgery to remove the gallbladder.
Your doctor may also recommend medication to help reduce the fever. In general, rest and drink plenty of fluids.
There are 2 main ways to prevent typhoid fever:
Careful food monitoring in areas where typhoid fever is prevalent:
- Drink only bottled water or water that has been boiled for at least one minute. This includes ice.
- Eat foods while they are still hot. Ensure that they are thoroughly cooked.
- Avoid any raw fruits and vegetables that cannot be peeled.
- Avoid raw shellfish.
- Avoid unpasteurized dairy products.
- Vaccination is recommended if you are planning to visit a country where typhoid fever is prevalent. Be aware that the vaccine is not always effective. Careful food monitoring is still important.
Centers for Disease Control and Prevention
World Health Organization
Public Health Agency of Canada
Bhan MK, Bahl R, Bhatnagar S. Typhoid and paratyphoid fever. Lancet. 2005;366(9487):749-762.
Bui YG, Trépanier S, Milord F, et al. Cases of malaria, hepatitis A, and typhoid fever Among VFRs, Quebec (Canada). J Travel Med. 2011;18(6):373-378.
Johnson KJ, Gallagher NM, Mintz ED, et al. From the CDC: new country-specific recommendations for pre-travel typhoid vaccination. J Travel Med. 2011;18(6):430-433.
Typhoid fever. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid_fever. Updated May 14, 2013. Accessed June 19, 2014.
Travel medicine. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 14, 2012. Accessed June 19, 2014.
Typhoid VIS. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/typhoid.html. Updated May 29, 2012. Accessed June 19, 2014.
Last reviewed May 2016 by David Horn, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.