Typhoid Fever

(Enteric Fever; Paratyphoid Fever)


Typhoid fever is an infection from bacteria. It can lead to serious illness and death. It needs to be treated right away.


The infection is caused by certain bacteria. It is in the stools and body fluids of an infected person. It can get passed into food and drinks. This can happen when an infected person has unclean hands. It can also happen if food and water are tainted with sewage.

Digestive System

Small intestines
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Risk Factors

Typhoid is common in places with poor sanitation. The risk of getting sick is highest in parts of India, Africa, and Asia.

Things that raise the risk are:

  • Having close contact with an infected person
  • Not having the typhoid vaccine
  • Having food or drink tainted by sewage
  • Not washing hands carefully
  • Having low stomach acid or taking acid reducers


Mild symptoms may be:

  • Low fever
  • Headache
  • Constipation—more common in adults
  • Diarrhea—more common in children
  • Rose-colored rash
  • Dry cough
  • A coating on the tongue
  • Lack of hunger

Severe symptoms may be:

  • High fever and chills—may last a long time
  • Belly pain
  • Changes in mental state


The doctor will ask about symptoms, health, and travel history. A physical exam will be done. The condition may be diagnosed with bone marrow biopsy, and blood and stool tests.


Typhoid is treated with antibiotics. Other options are:

  • Fluids by mouth or IV to treat dehydration
  • Medicines to lower fever or ease pain


In places where typhoid is common, the risk may be lowered by:

  • Getting a vaccine before traveling
  • Boiling water for drinking or cooking
  • Cooking food well
  • Washing hands often


Centers for Disease Control and Prevention
World Health Organization


Public Health Agency of Canada
Travel and Tourism—Government of Canada


Crump, J. Progress in typhoid fever epidemiology. Clin Infect Dis. 2019; 68(1): S4–S9.
Enteric fever (typhoid and paratyphoid fever). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/enteric-fever-typhoid-and-paratyphoid-fever. Accessed January 29, 2021.
Typhoid fever. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/typhoid-fever/ Accessed January 29, 2021.
Typhoid fever. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/infectious-diseases/gram-negative-bacilli/typhoid-fever. Accessed January 29, 2021.
Typhoid VIS. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/vaccines/hcp/vis/vis-statements/typhoid.html. Accessed January 29, 2021.
Last reviewed September 2020 by David L. Horn, MD, FACP
Last Updated: 1/28/2021

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