Who is most likely to get typhoid fever?

Anyone travelling to parts of the world where typhoid is common or where sanitary conditions are poor can contract the disease. Typhoid fever is commonly found in Africa, Asia, the Middle East, Central and South America, and parts of the Caribbean.

People with weakened immune systems—such as patients on steroid medication, people with HIV, cancer patients, or people receiving chemotherapy—have a much higher risk of contracting typhoid fever. The disease also infects the very young and very old at a higher rate than other age groups.

What are the symptoms of typhoid fever?

Typhoid usually presents with a high fever (39°-40° C/102°-104° F) along with abdominal pain and cramps, headache, and weakness. Some people also develop a rose or salmon coloured rash.

How is typhoid fever treated?

Typhoid can be treated by replacement of lost body fluids (rehydration) and antibiotics.

In some parts of the world, the typhoid bacteria have become resistant to certain antibiotics, so it is important to be treated with antibiotics that work against the local bacteria. Typical antibiotics used for typhoid fever are the sulfa antibiotics, ampicillin, or ciprofloxacin.

Can typhoid fever be prevented?

Although antibiotics will treat typhoid, they will not prevent it. There are typhoid vaccines available. One is a shot and one is taken by mouth. Neither vaccine is effective more than 50% to 55% of the time, so even if you get the vaccine, other prevention measures remain important.

The inactivated typhoid vaccine (the shot) needs at least two weeks to work and requires a booster dose every two years after the first vaccination.

The oral typhoid vaccine is a live vaccine and requires four doses, given two days apart, in order to be effective. It should be given at least a week prior to exposure to typhoid in order to provide maximum protection. A booster dose will be needed every five years after the initial vaccine course.

The typhoid fever vaccine is considered safe, but as with any medication, there can be some reactions.

Anyone suffering from signs of anaphylaxis (a life-threatening allergic reaction) after receiving either typhoid vaccine should seek medical help immediately. These signs include difficulty breathing, hives, swelling of the face or lips, and loss of consciousness.

What else can be done to prevent typhoid fever?

The best way to prevent typhoid fever is through good hygiene and observing food and water precautions, including the following:

• Do not eat food bought from street vendors or cooked in unsanitary conditions. If you must eat food from a street vendor, choose items that are well-cooked and served very hot.
• Avoid meat, poultry, seafood, and vegetables that are raw or undercooked.
• Avoid tap water (don’t forget about ice cubes)—don’t even use it to brush your teeth or to take medication with.
• If you drink bottled water, make sure the seal is intact before drinking.
• Consider drinking cold beverages directly from the bottle or can after drying it thoroughly, or use a straw.
• Avoid salads, uncooked vegetables, dairy products (cheese, milk), and any food washed in tap water that is not cooked thoroughly.
• Beware of buffets where food can be sitting out for long periods of time.