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Typhoid Fever

Typhoid fever is a reportable disease in Oklahoma.  Typhoid fever is a disease caused by the bacteria Salmonella Typhi.  In the United States, about 400 cases occur each year with approximately 75% of these cases acquired during travel to underdeveloped countries, including Asia, Africa, and Latin America.  Typhoid fever is uncommon in Oklahoma.  Since 1990, 0 to 3 cases have been reported each year.

People with this disease may experience mild to severe symptoms.  Persons with typhoid fever usually have a sustained fever as high as 103° to 104° F (39° to 40° C).  The symptoms of typhoid fever may also include weakness, headache, stomach pains, and loss of appetite.  Sometimes constipation, diarrhea, or a flat, rose-color rash may occur.  Symptoms usually occur within 8 to 14 days after exposure to the bacteria but can occur from 3 days to 60 days after exposure.

Typhi lives only in humans; there are no animals that carry it.  Persons with typhoid fever carry the bacteria in their bloodstream or intestinal tract while having symptoms.  In addition, some people recover from typhoid fever but continue to carry the bacteria; these people are called carriers.  Both ill persons and carriers can shed S. Typhi in their feces and sometimes urine.  A person can get typhoid fever if they eat or drink beverages that have been contaminated by feces from a person who is shedding S. Typhi, or if the bacteria get into the water used for drinking or washing uncooked foods like fruits and vegetables.

Typhoid fever is treated with antibiotics.  A person will usually recover in 2-3 days with prompt antibiotic treatment.  People that do not get prompt medical treatment may continue to have a fever for weeks or months, and as many as 10% will continue to shed the bacteria in their feces for 3 months after experiencing symptoms.  Some people (2% to 5%) recover from typhoid fever but continue to shed the bacteria, in their feces and sometimes urine, as permanent S. Typhi carriers. 

People most at risk for developing typhoid fever in the United States are those that have recently traveled to places where the disease is common. These places include South Asia, especially Pakistan, India, and Bangladesh. 

Typhoid fever is a reportable disease in Oklahoma. 

If you plan to travel to an area where the disease is common, use the following steps to protect yourself:

  • Get vaccinated against typhoid fever. Both injection and oral vaccines are available. Visit a travel clinic or health care provider to discuss your vaccination options. Plan to receive your vaccination in time to be fully protected before possible exposure.
  • Use careful selection of food and drink while you are in a developing country. Avoid raw fruits and vegetables that cannot be peeled.  Leafy vegetables like lettuce are easily contaminated and are very hard to wash well.
  • When you eat raw fruits or vegetables that can be peeled, wash your hands with soap and clean, running water, and then peel them yourself.  Do not eat the peelings.
  • Only use clean water. Buy it bottled or make sure it has been brought to a rolling boil for at least one minute before you drink it.
  • Ask for drinks without ice unless the ice is made from bottled or boiled water. Avoid popsicles and flavored ice made with water from an unknown source.
  • Only eat foods that have been thoroughly cooked and that are still hot and steaming.
  • Avoid foods and beverages from street vendors.

If you believe you have typhoid fever, contact your healthcare provider. Symptoms include sustained fever, weakness, stomach pain, headache, diarrhea or constipation, cough, and loss of appetite. Some also develop a rash with rose-colored spots. The only way to know for certain that you are ill with typhoid fever is to have a sample of blood or stool tested. Treatment for typhoid fever includes antibiotics.