Typhoid Fever: Symptoms, Causes Types & Treatment


Typhoid fever is a systemic infectious disease characterized by the fact that the patient has a high fever and abdominal symptoms caused by the infection of Salmonella typhi bacteria. Typhoid fever is more prevalent in underdeveloped and developing countries due to the scarcity of good, clean water.

It is estimated that there are 22 million cases of typhoid in the world, annually, of which 200,000 results to death. The countries where there are more cases are those of Southeast Asia, Indian subcontinent, Africa – especially Central and Western – and Latin America.

Typhoid Causes

Typhoid fever is caused by Salmonella typhi bacteria. The route of typhoid infection is oral. Humans are basically the only reservoir of the disease. Therefore, the infection is only acquired by ingesting water or food contaminated by these bacteria by the feces (rarely by the urine) of patients or carriers of the infection (fecal-oral transmission). 

Typhoid Prone Foods

Drinks and foods that are most often contaminated by Salmonella typhi bacteria are milk, cheese, ice cream, and other dairy products, shellfish that grow in places near wastewater disposal points, water-laden vegetables Faecal, eggs, some meats, and water. Direct contagion between the patient and the people around them is possible, but not frequent. Flies can also act as transmitters.

Symptoms of Typhoid

The symptoms of typhoid fever can range from mild manifestations to very serious symptoms that can even cause death. Initially, there is an incubation period of between one and six weeks, usually 1 or 2 weeks, time that varies depending on people and the number of bacteria in the body.

Medical experts indicate that the symptoms are mainly characterized by a high and sustained fever (39ºC-40ºC). In addition, people affected by this disease may experience weakness, abdominal pain, headache and loss of appetite. Hepatosplenomegaly (enlargement of the liver and spleen) is also common. In some cases, a rash of flat pink spots also appears.

Diarrhea typical of infections other serotypes of Salmonella (known salmonellosis ) is rare in typhoid fever.

Typhoid Prevention

There are two ways to prevent typhoid fever: One is not to eat water or food contaminated with the bacteria. To do this you have to drink drinking water and food free of bacteria or cooked since the heat destroys them. The source of your drinking water must be known and trusted. Properly heating water or food can also help prevent other gastrointestinal infections. 

Thus, the control of food handling and food preservation and proper treatment of wastewater, in order to avoid contamination of drinking water, together with the population’s health education, can be effective tools to prevent the spread of typhoid fever. Individual measures are fundamental:

  • Basic hygiene, such as washing your hands before eating.
  • Do not eat prepared food in street stalls.
  • Do not drink drinks with ice of doubtful origin.
  • Refrain from drinking infusions or tea in places that do not enjoy your trust, unless they have been treated properly or prepared with mineral water.
  • Do not ingest dairy products, unless you are completely sure that they have been pasteurized.
  • Vegetables should be eaten cooked and when they are still hot. If you prefer to consume them raw, you must first immerse them, for at least five minutes, in a solution of chlorinated drinking water with four drops of bleach with a concentration of 50 grams of chlorine per liter.
  • The fruit must be washed before peeling.
  • Fish and shellfish should not be eaten raw; they must be boiled for at least ten minutes before consumption

The other way to prevent it is through vaccination. There are two types of vaccines against typhoid fever, one oral and one injectable. The protection they confer is not permanent, so it is recommended to be revaccinated after three years.

Salmonella - Typhoid Fever Bacteria

Types of Typhoid

There are two kinds of Typhoid fever, namely:

  • Typhoid fever

This type is caused by the infection of the bacterium Salmonella typhi.

  • Paratyphoid fever

This second is caused by the bacterium Salmonella serotypes paratyphi A, B and C.

Typhoid Fever Diagnosis

Although the symptoms and history of the person’s disease may suggest typhoid fever, the diagnosis must be confirmed. Typhoid and paratyphoid fevers are diagnosed with bacterial culture. Typhoid fever patients must be subjected to tests before they can be declared conclusive.

  • Tests

In order for the diagnosis of the disease to be conclusive, patients have to be tested. The most recommended are the blood culture and co-culture. Other tests, such as serological tests, are not very specific and are currently in disuse.

Typhoid Fever Treatments

Typhoid fever treatment should always be followed under medical supervision. Apart from the general measures of adequate nutrition and hydration, there is a specific treatment with antibiotics. Normally drugs such as fluoroquinolones, third-generation cephalosporins or azithromycin are used. To eliminate the carrier state, Ciprofloxacin is mainly used in treating Typhoid fever.

Convalescence can last several months, but antibiotics decrease the severity and complications of typhoid fever, as well as the duration of symptoms.

During treatment, it is necessary for the person to feed frequently due to intestinal bleeding or other disorders of the digestive tract. In certain cases, intravenous feeding should be administered until the patient can digest the food.


Early detection is critical to prevent infection. In these circumstances, experts recommend isolating objects that are in contact with the patient. Some recommendations that can be followed are washing clothes and utensils used by the patient separately by immersing them in a solution with 200 milliliters of bleach for every five liters of water or, if you have a washing machine and dishwasher, use a washing program with temperatures higher than 80 degrees. In Africa, particularly Nigeria, this is often not the case as Typhoid fever are quite common.


In the absence of antibiotic treatment, the fever may persist for weeks or months and a significant percentage of those affected may die as a result of the complications of the disease. The mortality rate of Typhoid fever is estimated at around 15 percent of those affected. However, if the patient receives antibiotic treatment, the death rate is reduced below 1 percent of cases.

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