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.
Typhoid fever is an illness caused by the bacterium Salmonella Typhi (S. Typhi). It infects your small intestines (gut) and causes high fever, stomach pain and other symptoms. 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.
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Typhoid fever is most common in rural areas of developing countries where there isn’t modern sanitation. Countries in South and Southeast Asia, Central and South America, Africa and the Caribbean are most affected by typhoid. Travelers are most at risk when visiting Pakistan, India or Bangladesh.
Children are more likely to get typhoid than adults.
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.
Some people continue to be contagious with typhoid fever even after they’ve recovered (long-term carrier). You can spread typhoid for a year or more with no symptoms. It’s important to get tested for S. Typhi after you feel better to make sure you can’t spread it to other people.
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).
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:
Typhoid fever is caused by the bacterium S. Typhi. It lives in the gut (intestines) of infected people and can contaminate food and water.
Typhoid fever usually spreads through food or water contaminated with S. Typhi. This can happen if someone with typhoid touches something you eat or drink without washing their hands. It can also happen if waste water (water that has poop or pee in it) gets into water you drink or on food you eat.
You can get typhoid from another person if they don’t wash their hands after going to the bathroom. When they touch surfaces and objects (like phones or doorknobs) they can leave bacteria behind that can transfer to the next person who touches it.
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.
You can develop symptoms of typhoid fever gradually in four stages. Early treatment with antibiotics can keep you from progressing to later stages.
Your healthcare provider will use your symptoms, your travel history and lab tests to diagnose typhoid fever. They’ll give you a physical exam and listen to your heart and lungs.
It’s very important to tell your provider if you’ve traveled recently or think you’ve been exposed to typhoid, otherwise they might not know to test for it. They’ll also use the information to decide what treatment to give.
Your healthcare provider will take samples of body fluids or tissue to test for signs of S. Typhi. They might take samples of your:
You provider may also take X-rays (pictures of the inside of your body) to look for changes in your lungs.
Typhoid is treated with antibiotics. Some newer types of the bacteria are able to survive antibiotic treatments, so you’ll be treated with different antibiotics depending on what type of typhoid you have and where you got sick. Paratyphoid fever is also treated with antibiotics.
If you’re severely ill or have complications, you might need additional treatments. You’ll probably need to be admitted to the hospital for these treatments.
Your healthcare provider will treat typhoid fever with antibiotics, which may include:
If your case is severe, you may be treated with steroids, like dexamethasone.
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.
To take care of yourself, make sure you finish all of your medicines as prescribed by your healthcare provider. Ask your provider if it’s safe to take non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen (Advil® or Motrin®), naproxen sodium (Aleve®) or acetaminophen (Tylenol®) for pain or fever.
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.
The best way to reduce your risk of typhoid fever is to get vaccinated if you live in or are traveling to an area where it’s common. Hand washing and safe food handling are also important for limiting the spread of typhoid.
There are two vaccines for typhoid fever. They don’t last forever — you need to get additional doses to stay protected. They greatly reduce your risk but don’t guarantee you won’t get typhoid. Vaccines may provide some protection against paratyphoid fever, though this hasn’t been tested.
Vaccines are the best way to protect yourself from typhoid. But you should also take steps to avoid eating or drinking things that could be contaminated with S. Typhi or other bacteria. This is true both at home and when you’re traveling. Safe food handling practices include:
Depending on how soon you’re treated for typhoid, you can feel better in as little as a few days after starting antibiotics. It’s important to finish all of your medications as directed, even if you start to feel better. You may still be contagious for a long time after your symptoms go away.
Typhoid fever can be very serious. If you get treated as soon as possible, you’re less likely to have severe complications.
Some people with typhoid fever get sick again after they seemed to be fully recovered. This is called relapse. It usually happens about a week after finishing antibiotics, but in a few cases it’s happened weeks or months later. Your symptoms will probably be milder than the first time you had typhoid.
Call your healthcare provider immediately if your symptoms return. You’ll probably have to take another course of antibiotics.
If typhoid is left untreated, you’re at risk for severe complications, including:
Typhoid fever lasts seven to 10 days when treated soon after symptoms start. If untreated or if treatment starts later, it can last three weeks or longer. If you have complications or a relapse, it can take longer than that to fully recover.
Typhoid can be fatal if not treated quickly. But with modern medicines, most people survive and fully recover. Out of the millions of people diagnosed with typhoid fever each year, about 1% to 2% of cases are fatal.
Depending on where you work, you may not be able to go back until you test negative for S. Typhi. Even if you feel better, you could still spread typhoid to other people. Check with your employer or school to know what you need to do to return.
Yes, unlike most other illnesses, you can still be contagious with typhoid even when you no longer have symptoms. About 5% of people who have recovered from typhoid fever are still contagious a year later or longer. This is called a long-term carrier. It’s important to be tested after you feel better to make sure you can’t give typhoid to someone else.
Once you’ve recovered from typhoid fever, it’s important to check in with your healthcare provider for follow-up. You should be tested to make sure you’re no longer contagious. Be on the lookout for symptoms of relapse.
If you have a relapse or are still contagious, you may need additional treatment with antibiotics.
If you live in or have recently visited an area where typhoid is common and have symptoms of typhoid, see your healthcare provider right away. You’re most likely to recover quickly if you’re treated early.
Go to the ER immediately if you have:
Mary Mallon was a cook in New York in the late 1880’s. She was not sick with typhoid fever but instead was a carrier who could still spread the disease to others. As a danger to public health, the state of New York quarantined Mallon. They told her she couldn’t work as a cook anymore.
Mallon didn’t understand how she could spread disease without being sick and continued to work as a cook after her first quarantine. She was responsible for over 100 people getting sick with typhoid fever and at least five deaths. She’s thought to be the source of an outbreak of 3,000 cases of typhoid in New York. She was quarantined a second time, for the rest of her life, and has since been known as “Typhoid Mary.”
It once caused deadly outbreaks, but typhoid fever is now uncommon in many places, including the U.S., Canada, Australia and Western Europe. This is because of modern sanitation practices. Clean water for cooking and drinking is widely available, even in rural areas.
A note from Cleveland Clinic
Typhoid fever may seem like a plague of the past, but people all over the world still get very sick from it. If you live in or are traveling to an area where typhoid is common, getting vaccinated is the best way to keep from getting ill and spreading disease.
If you think you could have typhoid, see your healthcare provider right away. If you’ve recovered from typhoid, don’t be like Mary: get tested to make sure you can’t unknowingly spread disease to others.
Last reviewed by a Cleveland Clinic medical professional on 09/07/2022.
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