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Typhoid Fever

What is typhoid fever?
Typhoid fever is an infection of the intestines that spreads to the blood and other parts of the body. It is caused by the bacteria (germs), Salmonella typhi. For data on typhoid fever in New York City visit EpiQuery.
Who gets the disease?
Anyone can get typhoid fever, but it is more common in travelers visiting countries where the disease is common. Occasionally, local cases can be traced to exposure to a person who is a chronic (long-term) carrier.
How is typhoid fever spread?
Typhoid germs are passed in the stool (feces) and sometimes in the urine of infected people. The germs are spread by eating or drinking water or foods contaminated by stool from an infected person.
What are the symptoms of typhoid fever?
Symptoms may be mild or severe and may include fever, headache, diarrhea, constipation (stool that is hard and dry, or difficult to pass) rose-colored spots on the chest, back or stomach, and an enlarged spleen and liver. Relapses are common. Fatalities are less than 1% with antibiotic treatment.
How soon after infection do symptoms appear?
Symptoms generally appear one to three weeks after exposure.
For how long can an infected person carry the germ?
Persons who are infected can pass the typhoid germ in their stool for months or years, even if treatment with antibiotic medicine has been completed. Only about 3% of cases go on to become lifelong carriers of the germ, and this happens more often in adults than children.
How is typhoid fever diagnosed?
If your doctor suspects typhoid fever he/she will check your stool or blood for the germ.
How is typhoid fever treated?
Certain antibiotics such as ampicillin or ciprofloxacin are often used to treat typhoid fever.
Should an infected person be isolated or excluded from work or school?
Since the typhoid germs are in the stool, only people with active diarrhea who are unable to control their bowel habits (e.g., infants, young children, certain handicapped individuals) should be isolated. Most infected people may return to work or school when their stools become formed as long as they carefully wash their hands after using the toilet. Food handlers, health care workers, and children in day care must obtain the approval of the Health Department before returning to their routine activities. This requires follow-up stool testing to be sure that they are no longer infectious. Since infected persons may shed the bacteria for months to years, the Health Department requires repeat stool testing for at least 3 months for all patients with typhoid.
How can typhoid fever be prevented?
brochure A vaccine is available but it is usually used for people traveling internationally to countries where typhoid is very common. The best way to prevent typhoid fever is to pay close attention to food and water precautions while traveling to such countries.

People traveling to countries where typhoid is common, should take the following precautions:

  • Drink bottled water, or boil water for drinking.
  • Only eat food that has been thoroughly cooked.
  • Only eat fruits and vegetables that have been cooked or peeled.
  • Avoid undercooked or raw fish/shellfish.
  • Avoid eating foods or beverages from street vendors or restaurants that do not look clean.

► See Your Guide to Safe and Healthy Travel (PDF)
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Last Updated: March 2012