Typhoid fever is a life-threatening illness caused by the Salmonella Typhi bacteria, and it is spread by contaminated food and water.
Symptoms of typhoid include lasting high fevers, weakness, stomach pains, headache, and loss of appetite. Some patients have constipation, and some have a rash. Internal bleeding and death can occur, but are rare.
Fortunately, typhoid fever can be prevented, and can usually be treated with antibiotics. But if you are planning to travel outside the United States, you should know about typhoid fever and what steps you can take to protect yourself.
How is typhoid fever spread?
Salmonella Typhi lives only in humans. Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. In addition, a small number of persons, called carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed Salmonella Typhi in their feces (stool).
You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding Salmonella Typhi or if sewage contaminated with Salmonella Typhi bacteria gets into the water you use for drinking or washing food. Therefore, typhoid fever is more common in areas of the world where handwashing is less frequent and water is likely to be contaminated with sewage.
Once Salmonella Typhi bacteria have been consumed through food or drink, they multiply and spread into the bloodstream. The body reacts with fever and other signs and symptoms.
Typhoid fever is common in most parts of the world, except in industrialized regions such as the United States, Canada, western Europe, Australia and Japan, so travelers to the developing world should consider taking precautions. Travelers to Asia, Africa, and Latin America are especially at risk, and the highest risk for typhoid is in south Asia.
About 5,700 people get typhoid fever in the United States each year, and most cases (up to 75%) are acquired while traveling internationally. But in the rest of the world, the numbers are very different: There are about 22 million cases of typhoid fever, and 200,000 related deaths annually in developing nations.
What can travelers do to prevent typhoid fever?
Get vaccinated for typhoid
Ask your healthcare provider about a typhoid vaccine. This could be pills or a shot, and your doctor will help you decide which one is best for you. Unfortunately, the typhoid vaccine is only 50%-80% effective, so you should still be careful about what you eat and drink. (See tips below.)