| Disease
Fact Sheet Series:
What is typhoid fever?
Typhoid fever is a serious illness caused by a bacteria called Salmonella typhi.
In the U.S. about 400 cases occur annually, and 70% of these are acquired while traveling
internationally. Typhoid fever is still common in developing countries and affects about
12.5 million persons each year.
Who gets typhoid fever?
Any person can get typhoid fever, but those who travel, especially to developing
countries are at increased risk.
Where is typhoid fever found?
Typhoid fever is most common in non-industrialized countries. Travelers to Asia,
Africa, Eastern Europe, and Latin America are especially at risk.
How is typhoid fever spread?
Salmonella typhi bacteria are shed in the urine or stool of infected persons,
including chronic carriers. There are no known animal reservoirs for typhoid fever.
Typhoid fever is spread by eating or drinking contaminated food or water or by direct or
indirect contact with fecal material from infected persons.
What are the symptoms of typhoid fever?
Symptoms of Salmonella typhi infection may be mild to severe and can include
fever, headache, loss of appetite, constipation or diarrhea, and nonproductive cough.
How soon after exposure do symptoms appear?
The symptoms may appear 3 days to 3 months (depending on the number of bacteria
ingested), but onset of illness usually occurs 1-3 weeks after exposure.
For how long can an infected person carry Salmonella typhi?
The time period that a person can have Salmonella typhi in their stool is
variable. About 10% of untreated patients may shed infectious bacteria in their stool up
to 3 months after onset of symptoms and 2%-5% may become permanent shedders. These
permanent shedders are called chronic carriers.
Do infected people need to be isolated or excluded from work or
school?
Patients with Salmonella typhi should be excluded from all work involving food
handling, day care providers, or health care until at least 3 consecutive negative stool
cultures taken at least 24 hours apart and at least 48 hours after antibiotic therapy has
stopped and not earlier than one month after the onset of illness.
Should contacts be tested?
Household and close contacts should be excluded from high-risk occupations (i.e.,
food handlers, day care workers, and healthcare professionals) until at least 2 negative
stool samples taken 24 hours apart are obtained.
Can typhoid fever be treated?
Patients with typhoid fever or contacts to typhoid fever should immediately seek
medical attention. Typhoid fever can be effectively treated with antibiotic therapy.
Several new drugs have produced excellent results in the treatment for carriers, but
follow-up cultures are necessary to confirm cure.
How can typhoid fever be prevented?
When traveling to endemic areas for typhoid fever, avoid risky foods and drinks
(uncooked foods, non-bottled water or drinks made with ice). Consider vaccination against
typhoid at least 1 week before travel.
For more information, contact your
Local
Public Health Department
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Last Revised: March 20, 2008
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