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Typhoid Fever

(Enteric Fever; Paratyphoid Fever)

Definition

Typhoid fever and paratyphoid fever are serious infectious illnesses. They occur most often in developing countries where sanitation is poor.

Causes    TOP

Typhoid fever is caused by eating foods or drinking beverages contaminated with specific bacteria. Contamination can be present in:

  • Food or drinks handled by someone who is sick with typhoid fever
  • Food or drinks handled by someone who has no symptoms, but carries the bacteria
  • Water or food contaminated by sewage
  • Unpasteurized dairy products
  • Unrefrigerated poultry products

Digestive System

Small intestines
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Risk Factors    TOP

Factors that may increase your chance of typhoid fever include:

  • Not drinking boiled or bottled water
  • Eating raw shellfish
  • Eating fruits and vegetables that are raw or have been washed with contaminated water
  • Living in, or recent travel, to a country with poor sanitation
  • Decreased stomach acid, usually from taking acid reducing medications

Symptoms    TOP

Symptoms may include:

  • Fever often over a long period of time
  • Chills
  • Severe headaches
  • Constipation or diarrhea
  • Abdominal pain
  • Fatigue
  • Loss of appetite
  • Rose-colored spots on the body
  • Lightheadedness
  • Muscle pains
  • Swelling of the neck glands, liver, or spleen

Diagnosis    TOP

The doctor will ask about your symptoms and medical history. A physical exam will be done. Typhoid fever is usually diagnosed with a blood culture.

Treatment    TOP

Typhoid fever is treated with antibiotics.

Typhoid fever spreads easily until it is treated. In a small number of cases, people may become typhoid carriers even after the illness has passed. People who are chronic carriers can shed the contagious bacteria in their stool or urine. This condition can be treated with antibiotics or, in unusual cases, surgery to remove the gallbladder.

Your doctor may also recommend medication to help reduce the fever. In general, rest and drink plenty of fluids.

Prevention    TOP

There are 2 main ways to prevent typhoid fever:

  • Careful food monitoring in areas where typhoid fever is prevalent:
    • Drink only bottled water or water that has been boiled for at least one minute. This includes ice.
    • Eat foods while they are still hot. Ensure that they are thoroughly cooked.
    • Avoid any raw fruits and vegetables that cannot be peeled.
    • Avoid raw shellfish.
    • Avoid unpasteurized dairy products.
  • Vaccination is recommended if you are planning to visit a country where typhoid fever is prevalent. Be aware that the vaccine is not always effective. Careful food monitoring is still important.

RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov
World Health Organization
http://www.who.int

CANADIAN RESOURCES:

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References:

Bhan MK, Bahl R, Bhatnagar S. Typhoid and paratyphoid fever. Lancet. 2005;366(9487):749-762.
Bui YG, Trépanier S, Milord F, et al. Cases of malaria, hepatitis A, and typhoid fever Among VFRs, Quebec (Canada). J Travel Med. 2011;18(6):373-378.
Johnson KJ, Gallagher NM, Mintz ED, et al. From the CDC: new country-specific recommendations for pre-travel typhoid vaccination. J Travel Med. 2011;18(6):430-433.
Typhoid fever. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated May 14, 2013. Accessed June 19, 2014.
Enteric fever . EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated October 25, 2015. Accessed September 12, 2016.
Typhoid VIS. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated May 29, 2012. Accessed June 19, 2014.
Last reviewed May 2016 by David Horn, MD
Last Updated: 9/12/2016

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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