Typhoid Fever (Adult)

Typhoid fever is caused by the Salmonella typhi bacteria. Most cases of typhoid fever in the U.S. occur in people who have traveled to places in the world where typhoid fever is common. These include Asia, especially Pakistan, India, Africa, and Latin America. Infection occurs after a person consumes food or drinks that have been contaminated by infected stool from a typhoid carrier or if sewage contaminated with the bacteria gets into the water you use for drinking or washing food. Contaminated shellfish can also spread this illness.

Typhoid fever starts with chills, sweating, dry cough, headache, body aching, and abdominal pain. A high and recurring fever may then develop. Either diarrhea or constipation can occur. Diarrhea is more common in children and in people with HIV infection. Weight loss and weakness can last months.

In limited cases, people who recover from typhoid fever still have the bacteria in their stool without being sick. They are known as carriers. They can pass the infection on to others.

If untreated, the infection can cause intestinal perforation, heart damage, or other long-term problems.

Treatment is with antibiotics. Most people begin to feel better in a few days. People who are carriers need longer antibiotic treatment. Sometimes they need to have their gallbladder removed as part of treatment. 

Home care

  • Rest at home for at least the first few days.

  • Take the antibiotic medicines as directed until they're gone, even if you feel better or the healthcare provider tells you to stop. If you don't finish the medicine, the infection may come back and be harder to treat.

  • Fever increases water loss from the body. Drink plenty of fluids. Getting enough fluids is more important at this time than eating solid food.

  • Ask your healthcare provider before taking any over-the-counter medicines. Unless advised by your healthcare provider, don't take over-the-counter antidiarrheal medicines.

  • As symptoms lessen and you feel able, you can slowly return to eating normally. Don't drink alcohol.

Preventing the spread of infection

  • Washing hands well with soap and water is the best way to prevent the spread of infection. Wash your hands with plain soap and clean, running water for at least 20 seconds. Wash the palms and the tops of the hands, under the fingernails, between the fingers, and up both wrists.

  • Don't prepare or serve food for other people until your healthcare provider has determined the bacteria is no longer present in your body.

  • Clean the toilet after each use by the sick person.

  • Dispose of soiled linen and towels in a sealed container.

  • Before going to countries where typhoid fever is common, see your local public health department or your healthcare provider about a vaccination. Vaccination can help prevent typhoid fever. When traveling in these countries, don't eat raw peeled fruits or vegetables since they may have been prepared with contaminated water. Drink only bottled, boiled, or treated water.

  • Check the CDC's Travel Alert website at www.cdc.gov/typhoid-fever/index.html. It has up-to-date travel information on typhoid fever.

Follow-up care

Follow up with your healthcare provider, or as advised. If a stool (diarrhea) sample was taken, call in 2 days (or as directed) for the results.

When to get medical advice

Call your healthcare provider right away if any of the following occur:

  • Symptoms (including fever) don't start to improve within 24 hours of starting antibiotics

  • Diarrhea lasts more than 1 week after starting antibiotics

  • Continued vomiting (can't keep liquids down)

  • Diarrhea more than 5 times a day

  • Signs of dehydration, including dark urine, less urine, or extreme thirst

  • Severe abdominal pain or swelling

  • Jaundice (yellow skin and eyes)

  • Blood or mucus in the stool

  • Symptoms get worse or you have new symptoms

Call 911

Call 911 if any of the following occur:

  • Stiff neck or seizure

  • Loss of consciousness

  • Severe drowsiness, confusion, or change in behavior or mental function

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