What Is Typhoid Fever

  • Sherif El-SayedBachelor of Medicine, Bachelor of Surgery - MBBS, Health and Wellness, General, UCL, UK

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Typhoid fever is a grave bacterial infection, and its culprit is the bacterium known as Salmonella Typhi. If allowed to run its course untreated, it can turn into a life-threatening ordeal. In the following article, we aim to provide you with a thorough understanding of typhoid fever. This includes delving into its root causes; a look at the symptoms one might encounter the diagnostic processes used to identify it; the array of available treatments strategies for prevention, and more. If you're seeking knowledge about this condition or want to arm yourself with the necessary tools to protect yourself, you've come to the right place.

Understanding the genesis of typhoid fever

The typhoid fever bacterium infects humans mainly through contaminated water and food sources. It then can spread via something called the faeco-oral route - i.e. ingestion of contaminated products.

It continues to persist as a global health issue, with an increased burden in developing nations, where access to clean water and proper sanitation remains a persistent challenge. As previously mentioned, the main modes of transmission are as follows:

Contaminated food and water

The most prevalent method of transmission involves tainted edibles or beverages. This unfortunate occurrence transpires when these consumables come into contact with the excrement of an infected individual.

Direct contact

Close proximity to an infected person who is shedding the bacteria in their stool or urine can also pave the way for transmission. This unfortunate event often unfolds in settings with individuals living in close proximity to each other and in subpar hygienic conditions, such as lower-income households.

The risk factors for developing typhoid fever include:

  • Travelling to developing nations: Travelers who set foot in regions with inadequate sanitation and hygiene practices find themselves at an elevated risk of exposure
  • Residing in sanitary deserts: People dwelling in areas bereft of clean water access and proper sanitation facilities become more susceptible
  • Consuming raw or undercooked food and contaminated water: Consuming food that has not been adequately prepared increases the likelihood of infection; as does drinking water contaminated with the salmonella typhi bacterium
  • Contact with infected faeces: Both direct and indirect contact with the faecal matter of an infected person serves as a conduit for the transmission

Symptoms: the unwanted visitors

The symptoms of typhoid fever may vary in intensity from person to person and include:

  • Elevated body temperature: persistent fever soaring to 103°F (39.4°C) or beyond
  • Headaches abdominal discomfort: often localized to the right side
  • Changes in bowel habits: this may entail diarrhea or constipation, a waning appetite, bouts of nausea, and episodes of vomiting
  • Fatigue respiratory/general symptoms: Some individuals might develop a cough and experience muscular aches
  • Rose spots: A peculiar feature of typhoid fever is the appearance of rose spots. These are diminutive, pink or red blotches that emerge on the abdomen and chest

In severe cases, typhoid fever can unfurl into additional complications, encompassing delirium, hallucinations, seizures, shock, and potentially fatal conditions like intestinal perforation, internal bleeding, meningitis, pneumonia, and heart failure.

Unmasking typhoid fever: the diagnostic ritual

An accurate diagnosis of typhoid fever is important in facilitating timely intervention. Healthcare professionals wield an array of methods in their quest:

  • Blood test: A blood examination discerns the presence of antibodies specifically produced by the body to combat Salmonella Typhi, the bacterium that causes typhoid fever. The detection of these antibodies signals an ongoing infection
  • Stool culture: A stool culture entails examining a faecal sample to pinpoint the Salmonella Typhi bacteria. This helps validate the diagnosis
  • Bone marrow culture: In certain cases, resorting to a bone marrow culture might be warranted for diagnostic clarity. This procedure, albeit more invasive compared to blood or stool cultures, offers greater sensitivity, particularly in the early stages of infection

Healthcare providers take into account the patient's symptomatology, travel history, and other risk factors when trying to diagnose typhoid fever. Should one suspect themselves of harbouring this ailment, it is of paramount importance to seek medical attention immediately. Early diagnosis and prompt intervention form the bedrock for avoiding dire complications.

Treating and taming typhoid fever

Typhoid fever, being a formidable bacterial adversary, can yield fatal consequences if permitted to roam unchecked. It holds sway predominantly in the precincts of developing nations where sanitation and hygiene are often disregarded.

The treatment of typhoid fever revolves around the administration of antibiotics. The antibiotics most frequently employed are:

  • Ciprofloxacin
  • Ceftriaxone
  • Azithromycin

The selection of the antibiotic and the duration of the treatment depend on the severity of the infection and the local patterns of antibiotic resistance. In severe instances, typhoid fever might necessitate hospitalization, entailing the deployment of intravenous antibiotics.

Unveiling the shield: preventing typhoid fever

Prevention stands as the vanguard in the campaign against typhoid fever, significantly reducing its incidence. Effective preventive measures include:


The most potent shield against typhoid fever is vaccination. Several vaccines are available, and they are strongly recommended, especially for travellers embarking on journeys to high-risk territories. These vaccines are tried, tested, and trusted, offering enduring protection.

Hygienic practices with water and food

To mitigate the risk of infection, embrace the practice of sipping on boiled or bottled water, savouring well-cooked meals, steering clear of raw or undercooked foods, refraining from consuming raw fruits and vegetables unless washed or peeled with pristine water, and championing the cause of hand hygiene by washing hands consistently with soap and clean water.

Enhanced sanitation

Advocating for enhanced sanitation practices, including proper sewage disposal and access to clean water, serves as an effective bulwark against the propagation of typhoid.

Additional information:

  • Typhoid fever is estimated to cause 11-21 million cases of illness and 110-160,000 deaths worldwide each year
  • The majority of typhoid fever cases occur in children under the age of 5
  • The best way to prevent typhoid fever is to get vaccinated
  • If you are at risk for typhoid fever, there are steps you can take to reduce your risk, such as drinking only boiled or bottled water and eating well-cooked food
  • Typhoid fever is a serious infection, but it is treatable with antibiotics. If you think you may have typhoid fever, it is important to see a doctor right away

Current research on typhoid fever is focused on developing new vaccines, improving diagnostics, and understanding the mechanisms of antibiotic resistance.

One promising area of research is the development of oral vaccines against typhoid fever. Existing typhoid fever vaccines are administered by injection, which can be a barrier to vaccination in some settings. Oral vaccines are easier to administer and have the potential to reach a wider population.

Researchers are also working to develop new diagnostic tools for typhoid fever. Current diagnostic methods are complex and time-consuming, which can delay treatment. New diagnostics that are rapid, sensitive, and affordable are needed to improve the management of typhoid fever cases.

Finally, researchers are investigating the mechanisms of antibiotic resistance in Salmonella Typhi. This is important because increasing antibiotic resistance is a major threat to the treatment of typhoid fever. Understanding the mechanisms of antibiotic resistance can help researchers to develop new and effective treatments.

Here are some specific examples of current research on typhoid fever:

  • A team of researchers at the University of Oxford is developing a new oral typhoid fever vaccine that is based on a weakened Salmonella Typhi bacteria. The vaccine is currently in clinical trials in the UK and Malawi
  • A team of researchers at the University of Maryland is developing a rapid diagnostic test for typhoid fever that is based on a paper-based device. The test can detect the presence of Salmonella Typhi bacteria in a stool sample in as little as 15 minutes
  • A team of researchers at the Wellcome Sanger Institute is sequencing the genomes of Salmonella Typhi bacteria from different parts of the world to identify new genetic markers of antibiotic resistance. This research could help researchers to develop new antibiotics that are effective against drug-resistant strains of Salmonella Typhi


What are the complications of typhoid fever?

Complications can include intestinal perforation, internal bleeding, meningitis, pneumonia, heart failure, and, in severe cases, death.

How long does typhoid fever last?

Typhoid fever typically persists for 2-3 weeks, but in some cases, it can endure for a longer duration.

Is typhoid fever contagious?

Yes, typhoid fever is contagious and can be transmitted through contact with the faces of an infected person.

Can typhoid fever be prevented?

Yes, typhoid fever can be prevented through vaccination. There are several typhoid fever vaccines available, and they are recommended for travelers to high-risk areas. Other preventive measures include:

  • Drinking only boiled or bottled water
  • Eating well-cooked food and avoiding raw or undercooked items
  • Avoiding raw fruits and vegetables unless you can peel or wash them with clean water
  • Practising good hand hygiene


Typhoid fever, caused by Salmonella Typhi, is a severe bacterial infection primarily transmitted through contaminated food and water. It is most prevalent in developing countries and can lead to life-threatening complications if left untreated. Symptoms include high fever, headaches, abdominal pain, and digestive issues, among others. Early diagnosis through blood tests and stool cultures is crucial for effective antibiotic treatment. Preventive measures include vaccination, safe water and food practices, sanitation improvements, and education about hygiene and vaccination.


  1. Harris, Aaron M., et al. ‘Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention’. Annals of Internal Medicine, vol. 164, no. 6, Mar. 2016, p. 425. DOI.org (Crossref), https://doi.org/10.7326/M15-1840.
  2. Parry, Christopher M., et al. ‘Typhoid Fever’. New England Journal of Medicine, vol. 347, no. 22, Nov. 2002, pp. 1770–82. DOI.org (Crossref), https://doi.org/10.1056/NEJMra020201.
  3. Rehman, Inayat Ur. ‘Typhoid Conjugate Vaccine: A Solution to Protect from Typhoid Fever’. Journal of Wazir Muhammad Institute of Paramedical Technology, vol. 1, no. 2, Dec. 2021, p. 1. DOI.org (Crossref), https://doi.org/10.37762/jwmipt.9.
  4. Ray, Kurt. Typhoid Fever. Rosen Pub. Group, 2002.

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Nurah Ekhlaque

Masters in Biotechnology, Guru Ghasidas University

I'm a highly motivated and skilled biotechnology professional, known for my strong background in research and laboratory work. My proficiency extends to cryosectioning, immunohistochemistry, confocal imaging, and various molecular biology techniques. I am detail-oriented and dedicated to consistently producing high-quality results.

My educational journey led me to a Master's degree in Biotechnology from Guru Ghasidas Vishwavidyalaya, India. This academic foundation, combined with my practical experience, fuels my commitment to advancing scientific research and improving human health.

My practical experience includes roles as a Research Assistant at Saarland University in Germany and as an Internship Research Trainee at the All India Institute of Medical Sciences. In these positions, I mastered the use of cryosectioning, immunohistochemistry, and various laboratory techniques, consistently delivering high-quality data for scientific research.

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