17730 Typhoid Fever

Overview

Typhoid fever is a bacterial infection caused by a germ called Salmonella Typhi. It spreads through contaminated food and water. It causes a high fever, stomach pain, and weakness. With prompt medical care, most people recover fully.

Typhoid fever is rare in countries with clean water and good sanitation, like the United Kingdom. It is more common in parts of Asia, Africa, and South America where sanitation may be limited. Most cases in the UK happen in people who have traveled abroad.

Anyone can get typhoid fever, but people of all ages who live in or travel to areas with poor sanitation are at higher risk. Children and young adults are often affected in communities where the disease is common.

Symptoms

Common symptoms

• High fever that starts gradually and gets higher over a few days
• Headache
• Stomach pain and discomfort
• Weakness and tiredness
• Loss of appetite
• Dry cough or constipation at first, sometimes followed by diarrhea

Symptoms in children

• Fever may be the main symptom
• Children can appear tired and irritable
• Some children develop diarrhea or vomiting
• A rash of flat pink spots on the chest or belly may appear

Symptoms in older adults

• Fever may be less obvious
• Confusion or drowsiness can occur
• Constipation is common
• Dehydration can develop more quickly

Causes

Main causes

• Eating food or drinking water contaminated with Salmonella Typhi bacteria
• Close contact with an infected person who does not wash their hands properly
• Eating raw fruits or vegetables washed in contaminated water
• Using ice made from unclean water in some countries

Risk factors

• Traveling to regions where typhoid fever is common
• Living in areas with poor sanitation or limited clean water
• Having close contact with someone who is infected or recently recovered
• Working in a laboratory with the bacteria, though this is rare

When to see a doctor

See a doctor urgently if:

• You have a high fever and have recently traveled to a country where typhoid fever is common
• You have symptoms of typhoid and feel very unwell or dehydrated
• You have severe stomach pain or notice blood in your stool

Book a routine appointment if:

• You have a fever that has lasted more than a few days for no clear reason
• You feel weak, tired, and have a poor appetite along with a low-grade fever
• You have been in contact with someone who has typhoid fever and you feel unwell

Diagnosis

A doctor will ask about your symptoms, travel history, and any contact with sick people. To confirm the diagnosis, they will send a sample of your blood or stool to a laboratory.

Tests that may be done

• Blood test: the main way to confirm typhoid fever
• Stool (poo) sample: can also detect the bacteria
• Sometimes a urine sample or bone marrow test is needed in difficult cases

What to expect at your appointment

If your doctor suspects typhoid, they may start treatment before the test results come back. You will likely be asked to rest and drink plenty of fluids. It can take a few days for the lab results to confirm the infection.

Treatment

Typhoid fever is treated with antibiotics to clear the bacteria from your body. You will also need fluids and rest. Most people can be treated at home, but some need to go to hospital, especially if they have severe symptoms or complications.

Self-care at home

• Drink plenty of fluids, especially water or oral rehydration drinks, to prevent dehydration
• Rest as much as you can while your body fights the infection
• Eat small, soft, easily digested meals when you feel able
• Wash your hands often with soap and water, especially after using the toilet
• Stay away from work, school, or public places until your doctor clears you

Medical treatments

Doctors use antibiotics to treat typhoid fever. The choice of antibiotic depends on local resistance patterns, your health, and the severity of the illness. Do not treat yourself with over-the-counter medicines. Take all prescribed medicines exactly as directed, even if you feel better. In some cases, you may need fluids through a drip in the hospital.

When is surgery considered?

Surgery is rarely needed for typhoid fever. It may be required in rare cases if the infection causes a hole in the bowel (intestinal perforation) or bleeding that cannot be controlled. This is an emergency.

Living with this condition

While recovering from typhoid fever, take things slowly. Your body needs time to heal. You may feel tired for several weeks after starting treatment. Follow your doctor's advice about when it is safe to return to normal activities. Do not prepare food for others until your doctor confirms you are no longer carrying the bacteria.

Lifestyle tips

• Drink plenty of safe, clean fluids throughout the day
• Wash hands thoroughly, especially after the toilet and before handling food
• Cook all food properly and avoid raw food in high-risk areas
• Avoid sharing food, drinks, or utensils with others while unwell
• Keep your living space clean and hygienic to avoid passing the infection on

Diet and exercise

Eat a balanced diet to help you regain strength. Start with light foods like soups, rice, boiled vegetables, and bananas. Avoid spicy, greasy, or heavy meals until your stomach settles. Gentle activity, like short walks, is fine once your fever has gone, but do not do any intense exercise until you feel completely well.

Mental health and emotional wellbeing

Being ill with a serious infection can feel exhausting and worrying. You may feel anxious about your health or frustrated that recovery takes time. It is normal to feel this way. Talk to your doctor, friends, or family about how you are feeling.

Prevention

Yes, there are effective ways to prevent typhoid fever. These include drinking safe water, eating food that is cooked well, washing your hands regularly, and being careful during travel. If you are traveling to an area with poor sanitation, get advice from a travel health clinic.

Vaccines

Vaccines for typhoid fever are available for people traveling to countries where the disease is common. They do not provide complete protection, so you should still follow food and water precautions. Talk to your doctor or a travel health clinic about whether a typhoid vaccine is right for you.

Screening programmes

Routine screening for typhoid fever is not usually performed in people without symptoms. If you have traveled to a high-risk area and feel unwell, your doctor will decide whether you need testing.

Complications

If left untreated

• Intestinal bleeding (bleeding in the bowel)
• Intestinal perforation (a hole in the bowel, which is a surgical emergency)
• Inflammation of the heart muscle (myocarditis)
• Infections in the brain or spinal cord, such as meningitis
• Sepsis, a life-threatening reaction to infection

Long-term outlook

Typhoid fever can be very serious, but with prompt medical treatment, most people make a full recovery. Relief from fever usually happens within a few days after starting antibiotics. It may take weeks or months to regain your energy, but long-term problems are rare if you are treated early. Following your doctor's advice is the best way to ensure a good recovery.

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