For the most current updates about typhoid fever, please
CDC Travelers' Health at http://www.cdc.gov/travel/diseases/typhoid.htm
Frequently Asked Questions
Typhoid fever is a life-threatening illness caused by the bacterium
Salmonella Typhi .In the United States about 400 cases
occur each year, and 70% of these are acquired while traveling
internationally. Typhoid fever is still common in the developing
world, where it affects about 12.5 million persons each year.
Typhoid fever can be prevented and can usually be treated with
antibiotics. If you are planning to travel outside the United
States, you should know about typhoid fever and what steps you
can take to protect yourself.
is typhoid fever spread?
Salmonella Typhi lives only in
humans. Persons with typhoid fever carry the bacteria in their bloodstream
and intestinal tract. In addition, a small number of persons, called
carriers , recover from typhoid fever but continue to carry the
bacteria. Both ill persons and carriers shed S. Typhi in
their feces (stool).
You can get typhoid fever if you eat food or drink beverages that
have been handled by a person who is shedding S. Typhi
or if sewage contaminated with S. Typhi bacteria gets into
the water you use for drinking or washing food. Therefore, typhoid
fever is more common in areas of the world where handwashing is
less frequent and water is likely to be contaminated with sewage.
Once S. Typhi bacteria are eaten or drunk, they multiply
and spread into the bloodstream. The body reacts with fever and
other signs and symptoms.
in the world do you get typhoid fever?
Typhoid fever is common in most parts of the world except in industrialized
regions such as the United States, Canada, western Europe, Australia,
and Japan. Therefore, if you are traveling to the developing world,
you should consider taking precautions. Over the past 10 years,
travelers from the United States to Asia, Africa, and Latin America
have been especially at risk.
can you avoid typhoid fever?
Two basic actions can protect you from typhoid fever:
1. Avoid risky foods and drinks.
2. Get vaccinated against typhoid fever.
It may surprise you, but watching what you eat and drink when
you travel is as important as being vaccinated. This is because
the vaccines are not completely effective. Avoiding risky foods
will also help protect you from other illnesses, including travelers'
diarrhea, cholera, dysentery, and hepatitis A.
it, cook it, peel it, or forget it"
- If you drink water, buy it bottled or bring it to a rolling
boil for 1 minute before you drink it. Bottled carbonated water
is safer than uncarbonated water.
- Ask for drinks without ice unless the ice is made from bottled
or boiled water. Avoid popsicles and flavored ices that may
have been made with contaminated water.
- Eat foods that have been thoroughly cooked and that are still
hot and steaming.
- Avoid raw vegetables and fruits that cannot be peeled. Vegetables
like lettuce are easily contaminated and are very hard to wash
- When you eat raw fruit or vegetables that can be peeled, peel
them yourself. (Wash your hands with soap first.) Do not eat
- Avoid foods and beverages from street vendors. It is difficult
for food to be kept clean on the street, and many travelers
get sick from food bought from street vendors.
If you are traveling to a country where typhoid is common, you
should consider being vaccinated against typhoid. Visit a doctor
or travel clinic to discuss your vaccination options.
Remember that you will need to complete your vaccination at least
1 week before you travel so that the vaccine has time to take
effect. Typhoid vaccines lose effectiveness after several years;
if you were vaccinated in the past, check with your doctor to
see if it is time for a booster vaccination. Taking antibiotics
will not prevent typhoid fever; they only help treat it.
The chart below provides basic information on typhoid vaccines
that are available in the United States.
||Number of doses necessary
||Time between doses
||Total time needed to
set aside for vaccination
||Minimum age for vaccination
||Booster needed every...
(Vivotif Berna, Swiss Serum and Vaccine
||1 capsule by mouth
(Typhim Vi, Pasteur Merieux)
The parenteral heat-phenol-inactivated vaccine (manufactured by
Wyeth-Ayerst) has been discontinued.
are the signs and symptoms of typhoid fever?
Persons with typhoid fever usually have a sustained fever as high
as 103� to 104� F (39� to 40� C). They may also feel weak, or
have stomach pains, headache, or loss of appetite. In some cases,
patients have a rash of flat, rose-colored spots. The only way
to know for sure if an illness is typhoid fever is to have samples
of stool or blood tested for the presence of S. Typhi.
do you do if you think you have typhoid fever?
If you suspect you have typhoid fever, see a doctor immediately.
If you are traveling in a foreign country, you can usually call
the U.S. consulate for a list of recommended doctors.
You will probably be given an antibiotic to treat the disease.
Three commonly prescribed antibiotics are ampicillin,
and ciprofloxacin. Persons given antibiotics usually begin to
feel better within 2 to 3 days, and deaths rarely occur. However,
persons who do not get treatment may continue to have fever for
weeks or months, and as many as 20% may die from complications
of the infection.
fever's danger doesn't end when symptoms disappear
Even if your symptoms seem to go away, you may still be carrying
S. Typhi. If so, the illness could return, or you could
pass the disease to other people. In fact, if you work at a job
where you handle food or care for small children, you may be barred
legally from going back to work until a doctor has determined
that you no longer carry any typhoid bacteria.
If you are being treated for typhoid fever, it is important to
do the following:
Keep taking the prescribed antibiotics for as long as the doctor
has asked you to take them.
Wash your hands carefully with soap and water after using the
bathroom, and do not prepare or serve food for other people. This
the chance that you will pass the infection on to someone else.
Have your doctor perform a series of stool cultures to ensure
that no S. typhi bacteria remain in your body.