Typhoid fever is an illness caused by the bacterium Salmonella Typhi (S. Typhi). It infects your small intestines (gut) and causes high fever, stomach pain and other symptoms. Typhoid fever is also called enteric fever.

What are the symptoms of typhoid fever?

Typhoid fever gets its name from a high fever that can last for weeks if left untreated. It often gets progressively worse over a few days.

Other symptoms of typhoid fever include:

• Headache.
• Chills.
• Loss of appetite.
• Stomach (abdominal) pain.
• “Rose spots” rash, or faint pink spots, usually on your chest or stomach.
• Cough.
• Muscle aches.
• Nausea, vomiting.
• Diarrhea or constipation.

How does typhoid fever spread?

Typhoid fever usually spreads through food or water contaminated with S.Typhi. This can happen if someone with typhoid touches something you eat or drink without washing their hands. It can also happen if waste water (water that has poop or pee in it) gets into water you drink or on food you eat.

You can get typhoid from another person if they don’t wash their hands after going to the bathroom. When they touch surfaces and objects (like phones or doorknobs) they can leave bacteria behind that can transfer to the next person who touches it.

What are the stages of typhoid fever?

You can develop symptoms of typhoid fever gradually in four stages. Early treatment with antibiotics can keep you from progressing to later stages.

• Stage 1: You can start getting typhoid symptoms anywhere from five to 14 days after coming in contact with S. Typhi. The first symptom is a fever that gets higher over a few days — called “stepwise” since it goes up in steps. The bacteria is moving into your blood in this stage.
• Stage 2: Around the second week of fever, the bacteria is multiplying in your Peyer’s patches (part of your immune system that identifies harmful invaders). You’ll start experiencing abdominal pain and other stomach symptoms, like diarrhea or constipation. You might get “rose spots,” small pink dots on your skin that look like a rash.
• Stage 3: If not treated with antibiotics, the bacteria can cause severe damage, usually around the third week after your symptoms start. Some people get serious complications, like internal bleeding and encephalitis (inflammation in your brain).
• Stage 4: Stage four is when most people begin to recover. Your high fever begins to come down. S. Typhi can live in your gallbladder without causing symptoms, which means you may still be contagious even after you feel better.

Complications of typhoid

If typhoid is left untreated, you’re at risk for severe complications, including:

• Internal bleeding.
• Intestinal perforation (a hole in your intestines).
• Swollen or burst gallbladder.
• Neurological (brain) symptoms, including confusion, delirium and seizures.
• Swelling around your brain (meningitis).
• Bronchitis, pneumonia or other respiratory issues.
• Bone inflammation (osteomyelitis).
• Heart inflammation.
• Kidney failure.
• Miscarriage.

When should I see my healthcare provider about typhoid fever?

If you live in or have recently visited an area where typhoid is common and have symptoms of typhoid, see your healthcare provider right away. You’re most likely to recover quickly if you’re treated early.

When should I go to ER?

Go to the ER immediately if you have:

• High fever.
• Bloody or tarry poop (stool).
• Severe stomach pain.
• Coughing up or vomiting blood.
• Neurological symptoms like confusion or seizures.

Safe food practices for preventing typhoid fever

Vaccines are the best way to protect yourself from typhoid. But you should also take steps to avoid eating or drinking things that could be contaminated with S. Typhi or other bacteria. This is true both at home and when you’re traveling. Safe food handling practices include:

• Don’t make food for others if you’re sick.
• Wash your hands with soap and water before and after preparing food or eating and after going to the bathroom.
• Wash surfaces and utensils used for food prep and eating before and after use.
• If you’re unsure whether the food you’re eating is safe, eat mostly well-cooked or packaged food.
• Don’t drink untreated water or eat food prepared with untreated water. If you’re unsure, it’s safest to use bottled water to drink and cook with.