Typhoid Fever

(Enteric Fever; Paratyphoid Fever)

Definition

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

Causes

Typhoid fever is caused by eating foods or drinking beverages contaminated with the Salmonella 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

Factors that increase your risk 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

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

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

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

Prevention

There are two 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— recommended if you are planning to visit a country where typhoid fever is prevalent.

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RESOURCES

Centers for Disease Control and Prevention
http://www.cdc.gov

World Health Organization
http://www.who.int

CANADIAN RESOURCES

Health Canada
http://www.hc-sc.gc.ca

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

References

Bhan MK, Bahl R, Bhatnagar S.Typhoid and paratyphoid fever. Lancet. 2005 Aug 27-Sep 2;366(9487):749-62.

Bui YG, Trépanier S, et al. Cases ofMalaria, Hepatitis A, and Typhoid Fever Among VFRs, Quebec (Canada). J TravelMed. 2011;18(6):373-378.

Johnson KJ, Gallagher NM, 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: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid%5Ffever/. Updated May 14, 2013. Accessed June 19, 2014.

Typhoid fever. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated September 14, 2012. Accessed June 19, 2014.

Typhoid vaccine. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/typhoid.html. Updated May 29, 2012. Accessed June 19, 2014.

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