Typhoid Infection

What is typhoid infection?

Typhoid infection is a disease caused by the bacterium Salmonella Typhi. This illness is common in many countries of the world. Most cases diagnosed in the United States are acquired during travel to other countries. Typhoid infection should not be confused with the usually milder illness (salmonellosis) caused by other species of Salmonella, including S. Typhimurium.

Who gets typhoid infection?

Anyone can get typhoid infection but it occurs more often in people arriving from developing countries where the disease is common. Vaccination reduces the risk of infection, but vaccination is not routinely recommended in the United States.

How is typhoid infection spread?

Most people get typhoid infection by eating food or drinking water contaminated by people with the disease, including those who do not have any symptoms. Raw fruits and vegetables, milk, and shellfish are the types of foods most often associated with illness. Person-to-person spread can also occur.

What are the symptoms of typhoid infection?

Some people who are infected do not develop illness. Others might develop fever, headache, weakness, stomach pains and loss of appetite. Constipation or diarrhea can occur. Some people get “rose spots” on the trunk of the body. Symptoms might be mild, but typhoid infection can be life-threatening, especially if untreated.

How soon after exposure do symptoms appear?

The symptoms can appear from 3 days to over 60 days after exposure, with a usual range of 8–14 days.

How is typhoid infection diagnosed?

Laboratory testing of feces (stool) is the most common way to diagnose typhoid infection. The bacteria might also be identified in blood and other body fluids.

What is the treatment for typhoid infection?

Antibiotics and treatment to relieve symptoms are used to treat typhoid infection.

How can typhoid infection be prevented?

Typhoid infection can be prevented by careful hand washing after using a toilet or changing a diaper and before preparing or eating food. Persons who live in the house or have other close contact with a person who has typhoid infection should be tested for the disease and should not work in food handling until they have multiple negative tests. A vaccine is available that provides some protection for persons traveling to areas where the disease is common. Even if vaccinated, persons traveling to these areas still need to be careful about what food and water they consume. People in close contact with a typhoid carrier and lab workers exposed to the bacteria at their job should get vaccinated.

How long can an infected person spread this disease?

The bacteria can be spread to others as long as they remain in an infected person’s stool. Some people with typhoid infection can carry the bacteria for weeks to years. Approximately 10% of untreated typhoid infection patients excrete bacteria for three months after the onset of symptoms. About 2-5% become permanent carriers. Carriers are persons who are not ill with the disease but can spread the bacteria to others.

Should an infected person be excluded from work or school?

Most people may return to work or school after they recover from the disease, as long as they carefully wash their hands after using the restroom. People who are at higher risk of spreading the bacteria to others (e.g., food handler, healthcare worker, or child care worker or attendee) must have multiple negative tests for the bacteria and health department approval before they are allowed to return to their usual activities.

How can I learn more about typhoid infection?

  • If you have concerns about typhoid infection, contact your healthcare provider.
  • Call your local health department. A directory of local health departments is located at the VDH Local Health Districts page.
  • Visit the Centers for Disease Control and Prevention website at the CDC page on typhoid.

September 2018

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