Typhoid vaccine

The infection is transmitted through contaminated water and food.

Risky areas

Typhoid is more common in rural areas. However, those who visit cities can easily become infected too.

Seasonality

People get typhoid fever year-round, but there are some seasonal patterns that vary from region to region. Please see the table below.

Risky Activities

• Practicing poor hand hygiene
• Staying with a local family
• Adventurous eating (for example, tasting street food)
• Eating food prepared or touched by a typhoid-positive person

According to the New York City Department of Health and Mental Hygiene, Overall, 73 typhoid fever cases were reported from 2011 to 2015. In addition, around 80% of infected new yorkers had an international trip within the last 30 days.

Typhoid is a life-threatening disease. The symptoms appear gradually right after the end of incubation period and usually get worse if left untreated. Most patients have the mild form of the disease. About 10%–15% of patients have the severe form of typhoid, which may lead to death.

No symptoms

Infected people have no symptoms during the incubation period. Some infected people—secondary chronic asymptomatic carriers—never develop symptoms (learn more below).

Mild symptoms

People with a mild form of the disease will have these symptoms:

• Fever
• Headache
• Cough
• Bloody nose
• Abdominal pain
• Diarrhea

Severe symptoms

About 15% of infected people begin to experience severe disease-related symptoms two to three weeks after their first symptoms. These severe symptoms include the following:

• Slow heartbeat
• High fever
• Gastrointestinal hemorrhage (bleeding in the digestive tract)
• Intestinal perforation (a hole in the wall of the intestines)
• Encephalopathy (damage affecting the brain)

Duration of symptoms

The duration of symptoms depends on the availability of proper early treatment. If the patient is adequately treated, the disease will resolve in six days, on average. Otherwise, infected persons may experience long-term severe disease with a high risk of complications and death (up to 30% of infected people).
Up to 4% of patients develop asymptomatic chronic infection and continue to excrete bacteria in their stool for one year.

Typhoid is treated with antibiotics. It can be difficult to determine the antibiotic that the typhoid bacteria are not resistant to. Usually, it takes six days to treat the infection. If the results of treatment are not satisfactory by then, a different antibiotic should be given.
Some patients (about 10%) relapse or are re-infected, which requires additional treatment. This typically happens about one to three weeks after symptoms have resolved.
When treatment is adequate, only 0.2% of patients die from typhoid. However, if left untreated, 10%–30% of patients will die from disease-related complications.

The first symptoms of typhoid usually occur 6–30 days after exposure (most commonly 10–14 days).