Definition

Typhoid fever and paratyphoid fever are serious infectious illnesses.

They

occur most often in developing countries where sanitation is poor.

Causes

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

Risk Factors

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

Symptoms may include:

• Fever often over a long period of time
• Chills
• Severe headaches
• Constipation or diarrhea
• Abdominal pain
• Fatigue
• Loss of appetite
• Rose-colored spots on the body
• Lightheadedness
• Muscle pains
• Swelling of the neck glands, liver, or spleen

Diagnosis

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.

Treatment

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 gall bladder.

Your doctor may also recommend medication to help reduce the fever. In general, rest and drink plenty of fluids.

Prevention

There are two 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.

World Health Organization http://www.who.int

Public Health Agency of Canada http://www.phac-aspc.gc.ca

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.