Typhoid fever is caused by Salmonella typhi bacteria. Typhoid fever is rare in developed countries. It is still a serious health threat in the developing world, especially for children. Contaminated food and water or close contact with an infected person cause typhoid fever.
Signs and symptoms usually include:. Most people who have typhoid fever feel better a few days after they start antibiotic treatment, but a small number of them may die of complications. Vaccines against typhoid fever are only partially effective. Vaccines usually are reserved for those who may be exposed to the disease or who are traveling to areas where typhoid fever is common. Signs and symptoms are likely to develop gradually — often appearing one to three weeks after exposure to the disease.
See a doctor immediately if you think you might have typhoid fever. If you live in the United States and become sick while traveling in a foreign country, call the U. Consulate for a list of doctors. If you have signs and symptoms after you return home, consider seeing a doctor who focuses on international travel medicine or infectious diseases.
A doctor who is familiar with these areas may be able to recognize and treat your illness more quickly. Typhoid fever is caused by dangerous bacteria called Salmonella typhi. Salmonella typhi is related to the bacteria that cause salmonellosis, another serious intestinal infection, but they aren't the same. CDC estimates typhoid fever affects 5, people in the United States each year. CDC has not made estimates for Salmonella Paratyphi.
Most people diagnosed in the United States have traveled to places where the diseases are most common. Typhoid fever and paratyphoid fever are most common in parts of the world where water and food may be unsafe and sanitation is poor.
Travelers to South Asia, especially Pakistan, India, and Bangladesh, should take precautions to prevent infection. These diseases are spread through sewage contamination of food or water and through person-to-person contact. People who are currently ill and people who have recovered but are still passing the bacteria in their poop stools can spread Salmonella Typhi or Salmonella Paratyphi.
If you consume a food or drink contaminated with Salmonella Typhi or Salmonella Paratyphi, the bacteria can multiply and spread into the bloodstream, causing typhoid fever or paratyphoid fever. Skip directly to site content Skip directly to page options Skip directly to A-Z link.
This is impacting the choice of drugs available to treat typhoid. In recent years, for example, typhoid has become resistant to trimethoprim-sulfamethoxazole and ampicillin. Ciprofloxacin, one of the key medications for typhoid, is also experiencing similar difficulties. Some studies have found Salmonella typhimurium resistance rates to be around 35 percent. Typhoid is caused by the bacteria S. Washing fruit and vegetables can spread it, if contaminated water is used. Some people are asymptomatic carriers of typhoid, meaning that they harbor the bacteria but suffer no ill effects.
Others continue to harbor the bacteria after their symptoms have gone. Sometimes, the disease can appear again. People who test positive as carriers may not be allowed to work with children or older people until medical tests show that they are clear. Countries with less access to clean water and washing facilities typically have a higher number of typhoid cases.
Vaccines are not percent effective and caution should still be exercised when eating and drinking. Vaccination should not be started if the individual is currently ill or if they are under 6 years of age.
Anyone with HIV should not take the live, oral dose. The vaccine may have adverse effects. One in people will experience a fever. After the oral vaccine, there may be gastrointestinal problems, nausea, and headache.
However, severe side effects are rare with either vaccine. There are two types of typhoid vaccine available, but a more powerful vaccine is still needed. Typhi carrier. We document sexual transmission of typhoid fever, which may be acquired by means of oral and anal sex, as well as via food and drink.
Typhoid fever is endemic in the developing world but uncommon in the United States. Most cases occur among persons who have traveled to or among visitors from areas where disease is endemic [ 2 ]. Food or waterborne outbreaks occur as a result of fecal contamination with Salmonella enterica serotype Typhi by ill or asymptomatically infected persons [ 3 ].
All were men who had had sex with men, who were known to be at increased risk for enteric infection [ 4 ], and who denied recent foreign travel. We conducted an investigation to characterize the clinical cases, determine the extent of the outbreak, identify the mode of transmission, and implement prevention and control measures.
In early August , the Cincinnati Health Department initiated active hospital and laboratory surveillance for cases of typhoid fever. We defined a culture-confirmed case as isolation of S.
Typhi [ 5 ]. All 50 state health departments and laboratories were alerted to the cluster. We reviewed emergency department records for the interval of 23 June through 31 July at the University of Cincinnati Hospital for patients with typhoid-like illness. Because an earlier outbreak of Salmonella infection was caused by contaminated marijuana [ 6 ], we inquired about recreational drug use.
For each patient, we attempted to construct social and sexual networks to identify common friends and sex partners. We inspected the premises, interviewed all employees, and collected stool and serum samples from all food handlers. Stool specimens or rectal swab samples were obtained from suspected patients and were transported in Cary-Blair medium to the Cincinnati Health Department for culture on differential media and for enrichment in selenite broth. Typhi isolates were sent to the Ohio Department of Health for confirmation and for performance of PFGE subtyping and to the CDC for susceptibility testing by disk diffusion to ampicillin, ceftriaxone, chloramphenicol, ciprofloxacin, and trimethoprim-sulfamethoxazole [ 7 ].
Serum samples were sent to the CDC for Vi antibody testing [ 8 ]. We identified 6 symptomatic cases and 1 asymptomatic case patient A of culture-confirmed S. Typhi infection and 2 probable cases of typhoid fever figure 1 ; all cases occurred in men.
Date of onset of illness for the 6 symptomatic culture-confirmed cases ranged from 2 July to 12 August The median age of the patients was 34 years, the median temperature at presentation was Those with probable typhoid fever—patients F and I—had nearly identical illnesses, as did those with known HIV infection.
Patient A experienced a typhoid-like illness in May , 2 weeks after returning from Puerto Rico. On 15 May, he presented to a hospital emergency department with a 3-day history of chills, fever, malaise, myalgias, and arthralgias. His temperature was No specimens were obtained for culture, and he made a full recovery within days. However, after case-finding efforts led to his identification as a sex partner of a symptomatic patient with culture-confirmed S.
Typhi infection, stool specimens obtained on 4, 15, and 23 August yielded S. Typhi on culture. Presence of gallstones was documented by ultrasonography on 11 September. Beginning on 23 August, patient A received trimethoprim-sulfamethoxazole for 2 weeks followed by ciprofloxacin for 3 weeks for treatment of his carrier state [ 5 ]. The results of 4 follow-up cultures of fecal specimens, which were obtained on 15, 18, and 19 September and 4 October , were negative. We identified no additional cases after 9 September Three reported a history of both oral-anal and oral-genital sex; 1 reported oral-anal, oral-genital, and receptive anal sex; 1 reported oral-anal and receptive and insertive anal sex; 1 reported receptive anal sex only; and 1 reported having licked the hand he used to stimulate his partner.
The eighth symptomatic patient denied having had sex with men but reported that the onset of illness began 2 weeks after he spent a weekend as the sole houseguest of patient A. No common source of food, drink, or marijuana was identified. Four patients had S.
Typhi isolated only from blood cultures, 2 only from cultures of stool specimens, and 1 from both blood and stool cultures. Typhi patterns in the CDC database. None of the 8 patients, including patient A, had elevated Vi antibody titers. None of the Bar A employees had elevated Vi antibody titers or had S. Typhi isolated from stool samples. We conclude that this outbreak of infection resulted from sexual transmission of S.
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