What is typhoid fever?

Typhoid fever is a bacterial infection that can be life-threatening. Most cases of typhoid fever occur in developing nations. However, the disease can occur anywhere, including industrialized countries like the U.S.

Who is most at risk for getting typhoid fever?

Individuals are most at risk for the disease in developing nations where good sanitation is lacking and people have limited access to clean water and safe foods. These areas are primarily in parts of Asia, Central and South America, Africa, and the Caribbean. Typhoid fever is less common in industrialized nations like the U.S. Most cases of typhoid fever in developed countries occur in returning travelers who can spread the illness to others or in contaminated foods. It is estimated that approximately 5,700 cases occur each year in the U.S. (but only 400 are confirmed).

What causes typhoid fever?

The bacterium Salmonella typhi (S. typhi) causes typhoid fever. The bacteria spreads through contaminated food, drink, or water. People infected with Salmonella typhi carry the bacteria in their intestinal tract and blood.

Salmonella typhi is shed (discarded from the body) in feces (stool). You may get typhoid fever if you ingest food or beverages prepared by someone who is shedding the bacteria and who does not wash their hands properly. In less developed countries, sewage containing Salmonella typhi may contaminate local water supplies.

In some cases, people who have previously had typhoid fever still carry Salmonella typhi bacteria. These people are carriers of the disease. They may spread the infection even when they have no symptoms (the famous case of “Typhoid Mary” in the U.S.).

What are the symptoms of typhoid fever?

In early stages of the disease, symptoms include: abdominal pain, fever, and a general feeling of being unwell. These initial symptoms are similar to other illnesses.

As typhoid fever gets worse, symptoms often include:

  • High fever of up to 104 degrees Fahrenheit
  • Headaches
  • Abdominal pain, constipation then perhaps diarrhea later
  • Small, red spots on your abdomen or chest (rose-colored spots)
  • Loss of appetite and weakness

Other symptoms of typhoid fever include:

  • Body aches
  • Bloody stools
  • Chills
  • Severe fatigue
  • Difficulty paying attention
  • Agitation, confusion, and hallucinations (seeing or hearing things that are not real)

Last reviewed by a Cleveland Clinic medical professional on 03/01/2018.


  • Centers for Disease Control and Prevention. Typhoid Fever. Accessed 3/19/18.
  • World Health Organization. Typhoid. Accessed 3/19/18.
  • National Organization for Rare Disorders. Typhoid. Accessed 3/19/18.

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