Typhoid Fever: Causes, Symptoms, and Treatment

Fact checked by Olga Sadouskaya, MD
Clinical Pharmacologist, Chief Medical Officer

Can rose spots be a sign of typhoid fever? Are there any side effects of the typhoid vaccination? Continue reading to learn about the symptoms and causes of typhoid fever, as well as its incubation period.

What is typhoid fever?

Typhoid fever is an illness that can lead to symptoms like diarrhea and a rash. Salmonella typhi (S. Typhi) is the most prevalent kind of bacterium responsible for the condition.

In infected individuals, the bacteria can be found in the blood and intestines. It is transmitted from one person to another by unprotected, direct contact with the feces of an infected individual.

There are no animal hosts for typhoid, meaning it can only be passed from person to person.

It is believed that S. Typhi enters the body via the mouth and stays in the intestines for one to three weeks. After that, it passes through the lining of the digestive tract and into the person’s bloodstream.

After entering the bloodstream, it travels to many organs and tissues throughout the body. S. Typhi is able to hide from the host’s immune system by hiding inside the cells.

Typhoid fever can be diagnosed if the bacterium Salmonella typhi is found in a patient’s blood, stool, urine, or bone marrow sample.

A man with stomach ache because of typhoid fever

Many species of Salmonella bacteria can be responsible for foodborne salmonellosis, but the specific types S. Typhi and S. Taratyphi can cause typhoid fever.

Typhoid may cause symptoms such as a high fever, vomiting, and diarrhea. Antibiotics can be an effective treatment if the illness is caught in its early stages. Typhoid fever, if left untreated, may be lethal.

Symptoms and causes of typhoid fever

In most cases, the incubation period lasts between one and three weeks, and the disease typically lasts between three and four weeks. Among the symptoms are:

  • Poor appetite
  • Headaches
  • Aching and pain all over the body
  • Fever of 104 F or higher
  • Rash, or rose spots
  • Lethargy
  • Diarrhea

It is normal for patients to develop chest congestion, and stomach pain and discomfort are also frequent symptoms. Without complications, those with typhoid fever may begin to improve during the third and fourth weeks.

After feeling better for one to two weeks, around 10% of individuals will continue to have their original symptoms. In fact, people who have been treated with antibiotics are more likely to have relapses.

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S. Typhi may be passed from person to person by consuming tainted food, drink, or water. The germs may enter your body if you consume anything that has been infected with the bacteria.

After entering your intestines, the bacteria make their way into your bloodstream and then can infect other parts of the body, including the lymph nodes, gallbladder, liver, and spleen.

Certain individuals may acquire the typhoid carrier S. Typhi bacterium and continue to excrete it in their feces for an extended period of time, therefore contributing to the spread of the illness.

The risk of contracting typhoid fever is higher in underdeveloped nations. The majority of typhoid fever cases in the United States are brought in from other nations where the disease is more prevalent.

What’s typhoid fever’s incubation period?

Typhoid’s incubation period is one to two weeks. That means that after being infected with the Salmonella typhi bacterium, a person will often begin to experience the symptoms of typhoid fever between one and two weeks later.

After receiving therapy, patients with typhoid fever should have a rapid improvement in their symptoms within three to five days.

Without treatment, typhoid fever will often worsen over the course of a few weeks, and there is a considerable possibility of life-threatening complications.

If treatment is not received, it may take many weeks or even months to completely heal, and symptoms may reappear in the meantime.

How to treat typhoid fever

Antibiotics are the only medication that has been shown to be effective for typhoid. Ciprofloxacin is the antibiotic that medical professionals most often prescribe to patients who aren’t pregnant.

Other antibiotics that a doctor may prescribe include the following:

  • Sulfamethoxazole/trimethoprim
  • Chloramphenicol
  • Ampicillin

A person with typhoid fever needs to stay hydrated by drinking enough water.

Surgical intervention could be required in more serious situations, such as when the bowel has been perforated.

The rising antibiotic resistance of S. Typhi is a concern, just as it is with a number of other bacterial diseases.

Medication to treat typhoid fever

There have been epidemics of typhoid strains that are resistant to several drugs, such as the outbreak that occurred in Pakistan in 2018, when patients were resistant to five different kinds of antibiotics.

For this reason, the Centers for Disease Control and Prevention advise preventive measures, such as:

  • Increasing vaccination
  • Enhancing the state of sanitation and hygiene
  • Implementing improved methods for tracking those who are infected in order to reduce the spread of illness

If the disease is left unattended, the symptoms of typhoid can be fatal.

Typhoid fever rose spots indicate a rash that may appear in some people infected with S.Typhi. Typhoid rose spots are clumps of bacteria that accumulate in the bloodstream.

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What are the side effects of the typhoid vaccination?

Many drugs and vaccines have side effects, but some are more serious than others, and not everyone will experience every (or any) side effect. For serious side effects, it’s always important to seek immediate medical attention. Potential typhoid oral vaccination side effects include:

  • Pain from the shot, redness or swelling at the site of the injection, fever, headache, and overall discomfort
  • Stomach discomfort, diarrhea, nausea, and vomiting
  • After medical treatments, including vaccinations, some patients experience fainting.
  • Notify your physician if you have symptoms such as ringing in the ears, visual problems, or dizziness.
  • Trembling, general sick feeling
  • A seizure
  • A sensation of being light-headed and on the verge of passing out

As is the case with all medications, there is a very slim possibility that typhoid shot side effects might result in a life-threatening allergic response.

When to seek medical help

Please get in touch with your health care provider if you experience any of the following:

  • You are aware that you have been in contact with someone who has typhoid fever.
  • You have recently been in a location where there are individuals who are infected with typhoid fever, and you have developed signs of the disease.
  • You previously had typhoid fever, and its symptoms have just resurfaced.
  • You have significant stomach discomfort, a reduction in the amount of urine you pass, and other new symptoms.

If you suspect you could have typhoid fever, you should see a doctor as soon as possible. If you are a citizen of the United States and fall ill while you are traveling in a different country, you should contact the United States Consulate for a list of local medical professionals.

If you return home and continue to have signs and symptoms, you may want to see a physician specializing in infectious illnesses or international travel medicine. A physician who is experienced in these areas may be able to diagnose and treat your condition more rapidly.

Key takeaways

Typhoid fever is an illness that is brought on by the S. Typhi bacteria. The most prominent symptoms include a high temperature, abdominal cramping and vomiting, and diarrhea. There is a possibility of major complications in some instances.

Without treatment, as many as 30 percent of typhoid cases result in death. This incidence is between 1 and 4 percent when antibiotic therapy is received and there are no complications.

If you live in an area where typhoid is widespread or are going to an area where it is common, be sure to exercise extreme care near food and water that may be contaminated and wash or sterilize your hands often.

March 3, 2023