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Typhoid fever is an acute illness associated with fever caused by the Salmonella enterica serotype Typhi bacteria. It can also be caused by Salmonella paratyphi, which causes food poisoning. The bacteria are deposited in water or food by a human carrier and spread to other people in the area.


The incidence of typhoid fever in the United States has decreased since the early 1900s when tens of thousands of cases were common. Today, less than 400 cases are reported annually in the United States, primarily in people who have recently traveled to Mexico and South America. This improvement is the result of better environmental sanitation. India, Pakistan, and Egypt are high-risk areas for developing this disease. Worldwide, typhoid fever affects more than 21 million people annually, with about 200,000 people dying.

Symptoms include abdominal painfever, and a general feeling of being unwell in the early stages. 


As typhoid fever gets worse, symptoms often include:

  • High fever of up to 104 degrees Fahrenheit

  • Headaches

  • Abdominal pain, constipation, then possibly diarrhea later

  • Small, red spots on your abdomen or chest

  • Loss of appetite and weakness


Other symptoms of typhoid fever include:

  • Body aches

  • Bloody stools

  • Chills

  • Severe fatigue

  • Difficulty paying attention

  • Agitation, confusion, and hallucinations 

Typhoid is spread by contact and ingestion of infected human feces, which can happen through an infected water source or when handling food.


The following are some general rules to follow when traveling to help minimize the chance of typhoid infection:


  • Drink bottled water, preferably carbonated.

  • If unable to use bottled water, ensure water is heated on a rolling boil for at least one minute before consuming.

  • Be wary of eating anything that has been handled by someone else.

  • Avoid eating at street food stands, and only eat food that is still hot.

  • Do not have ice in drinks.

  • Avoid raw fruit and vegetables, peel fruit yourself, and do not eat the peel.

The CDC recommends vaccination for people traveling to places where typhoid fever is common, such as Africa, South America, and South Asia, especially India, Pakistan, or Bangladesh. Talk with your healthcare provider to discuss options.


Two typhoid fever vaccines are available in the United States.


  • Oral vaccine: Can be given to people at least six years old. It consists of four pills taken every other day and should be finished at least one week before travel.

  • Injectable vaccine: This can be given to people at least two years old and should be given at least two weeks before travel.


Typhoid vaccines are not 100% effective. Always practice safe eating and drinking habits to help prevent infection.


Typhoid vaccines lose effectiveness over time. The injectable vaccine requires a booster every two years, and the oral vaccine requires a booster every five years. Taking antibiotics will not prevent typhoid fever; they only help treat it.

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