Typhoid fever: symptoms, testing and treatment

Typhoid fever is a bacterial infection spread through food or water contaminated with infected stool.

It is also called enteric fever. The infection can affect the whole body, rather than remaining only in the gut, and needs medical assessment. A person can become infected after consuming contaminated food or water or through poor hand hygiene in settings where sanitation is limited.

Typhoid fever commonly presents with fever, weakness, headache, reduced appetite and stomach discomfort. Some people have diarrhoea or constipation. Symptoms may build over several days and can resemble other infections, which is why testing matters.

Get urgent medical care for confusion, fainting, severe or increasing abdominal pain, repeated vomiting, inability to keep fluids down, blood in stool, or signs of dehydration such as very little urine. These changes need prompt evaluation.

Typhoid fever is caused by Salmonella Typhi bacteria. The bacteria leave an infected person in stool and can reach another person through contaminated hands, drinking water, ice, raw foods or food handled without adequate hygiene. Someone may continue to carry bacteria after feeling better, so completing the clinical plan and following public-health advice matters.

Without effective treatment, symptoms can worsen and the infection can lead to serious intestinal or whole-body complications. With the right antibiotic selected by a clinician, symptoms often begin to settle, but recovery still requires rest, fluids and follow-up. Finish the prescribed course unless the prescriber changes the plan.

Exposure is more likely when travelling to or living in areas where typhoid is present and safe water or sanitation is unreliable. Eating uncooked food, drinking untreated water, close contact with an infected person, or preparing food without thorough handwashing can increase the chance of exposure.

The clinician will ask about symptoms, travel, food and water exposure, medicines and other illnesses. Blood, stool or other samples may be tested to look for the bacteria. Testing can also help identify which antibiotics are likely to work, because resistance patterns vary.

Treatment usually includes antibiotics chosen for the person and the likely susceptibility of the bacteria. Fluids, oral rehydration, rest and simple foods may help during recovery. Do not use leftover antibiotics or share medicines: an unsuitable antibiotic can delay effective care. A clinician may recommend hospital care when the illness is severe, complications are suspected or drinking is difficult.

Take medicines exactly as directed and keep drinking safe fluids in small, frequent amounts if nausea is present. Wash hands carefully after using the toilet and before preparing food. Ask the clinician when it is appropriate to return to work, school or food handling, because extra precautions may be needed.

Untreated typhoid fever can cause severe dehydration, intestinal bleeding or a hole in the intestine, and infection can spread beyond the gut. Worsening belly pain, a swollen abdomen, black or bloody stool, confusion or collapse requires urgent assessment.

Use safe drinking water, eat food that is thoroughly cooked and served hot, and wash hands with soap and safe water before eating or preparing food. A typhoid vaccine may be advised for some travellers or people with particular exposure; vaccination complements food and water precautions.

A GP, urgent-care clinician or infectious-disease team can assess suspected typhoid fever. Seek care promptly after travel or a relevant exposure if fever develops, especially when it comes with stomach symptoms or increasing weakness.