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Typhoid Fever Typhoid Fever
by Kimberly Allen RN Typhoid fever is an acute bacterial infection caused by certain strains of the salmonella bacteria.  According to the World Health... Typhoid Fever

by Kimberly Allen RN

Typhoid fever is an acute bacterial infection caused by certain strains of the salmonella bacteria.  According to the World Health Organization there are approximately 23 million people diagnosed with typhoid fever resulting in over 500,000 deaths worldwide every year.  Because of improved sanitation the incidence in the US is only  about 400 cases per year and most of those contracted the illness while traveling abroad.  With winter approaching many people plan for a nice warm get away to beaches in places like Mexico and Brazil to get a break from the cold.
The most common strain of salmonella responsible for typhoid fever is the salmonella typhi.  This strain only lives in humans.  The bacteria is in the bloodstream and intestinal tract of people infected with typhoid fever.  There are also people that have recovered from typhoid fever, yet they still have the bacteria present in their gallbladder and intestinal tract, they are carriers.  You get typhoid fever the same as most other “food poison” illnesses, by eating or drinking contaminated food and/or beverages.  However, as people can be “carriers” close contact with someone that is a carrier can also cause the spread of typhoid fever.
The symptoms of typhoid fever usually manifest anytime from 1 week to a month after being exposed to the bacterial  that’s why when people that travel to a place where typhoid is endemic they usually do not develop symptoms until after they have returned home.  The early symptoms of typhoid fever are similar to the flu, fever, headache, weakness and fatigue with a poor appetite and a dry cough.  However, in typhoid fever the fever starts low  but steadily climbs to as high as 104F or more and stays there.  If you’re one of those that the symptoms didn’t start until a month or so after becoming infected you may have forgotten the possibility of typhoid infection and try to treat it as though it is the flu.  Then by the second week the illness progresses to the second stage of typhoid fever.  In the second stage the fever persists at around 104F, your abdomen will become distended and you will experience either severe constipation or severe diarrhea as well as weight loss.  Then by the third week if you have not received treatment you most likely will become delirious and lying in bed exhausted.  It is at this point that life threatening complications can develop if treatment is not initiated.
Typhoid fever is caused by a bacterial infection so antibiotic therapy is the only treatment that is effective against it.  The medication prescribed the most frequently for typhoid fever in the US is Cipro.  However, pregnant women and some children can not take Cipro so they are given injections of Rocephin.  Unfortunately these medications can produce side effects, in addition to that long term use of these antibiotics can lead to antibiotic resistance strains of bacteria developing.
If you are planning on traveling abroad, research your destination to find out if typhoid fever is endemic to that area.  If the area you are planning to visit does have typhoid fever you can take preventive measures before you leave.  There are currently two vaccines available.  One is a one time injection given approximately 2 weeks before you plan to leave and the other is a series of 4 capsules, 1 taken every other day before leaving.  Unfortunately neither vaccine is 100% effective so it’s also important to take other precautions like frequent hand washing with soap and water before preparing or eating food and after using the bathroom.  Always drink only bottled beverages including water and do not use ice from the machines.  Avoid raw fruits and vegetables as they may have been washed in contaminated water.  You can still travel to your chosen destination and enjoy your time there without worrying about becoming ill if you take precautions.

Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at