Typhoid fever

Typhoid fever is caused by Salmonella typhi bacteria. Typhoid fever is rare in industrialized countries. However, it remains a serious health threat in the developing world, especially for children.

Typhoid fever spreads through contaminated food and water or through close contact with someone who's infected. Signs and symptoms usually include high fever, headache, abdominal pain, and either constipation or diarrhea.

When treated with antibiotics, most people with typhoid fever feel better within a few days, although a small percentage of them may die of complications.

Vaccines against typhoid fever are available, but they're only partially effective. Vaccines usually are reserved for those who may be exposed to the disease or are traveling to areas where typhoid fever is common.

Symptoms Causes Risk factors Complications Prevention

Although children with typhoid fever sometimes become sick suddenly, signs and symptoms are more likely to develop gradually — often appearing one to three weeks after exposure to the disease.

1st week of illness

Once signs and symptoms do appear, you're likely to experience:

  • Fever, that starts low and increases daily, often to as high as 103 or 104 F (39.4 or 40 C)
  • Headache
  • Weakness and fatigue
  • Dry cough
  • Loss of appetite
  • Abdominal pain
  • Diarrhea or constipation
  • Rash

2nd week of illness

If you don't receive treatment for typhoid fever, you may enter a second stage during which you become very ill and experience:

  • Continuing high fever
  • Either diarrhea or severe constipation
  • Considerable weight loss
  • Extremely distended abdomen

3rd week of illness

By the third week, you may:

  • Become delirious
  • Lie motionless and exhausted with your eyes half-closed in what's known as the typhoid state

Life-threatening complications often develop at this time.

4th week of illness

Improvement may come slowly during the fourth week. Your fever is likely to decrease gradually until your temperature returns to normal in another week to 10 days. But signs and symptoms can return up to two weeks after your fever has subsided.

When to see a doctor

See a doctor immediately if you suspect you have typhoid fever. If you become ill while traveling in a foreign country, call the U.S. Consulate for a list of doctors. Better yet, find out in advance about medical care in the areas you'll visit, and carry a list of the names, addresses and phone numbers of recommended doctors.

If you develop signs and symptoms after you return home, consider consulting a doctor who focuses on international travel medicine or infectious diseases. A specialist may be able to recognize and treat your illness more quickly than can a doctor who isn't trained in these areas.

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