Typhoid Fever Symptoms: Signs, Prevention, and Travel Safety

Typhoid fever is a serious bacterial infection caused by Salmonella typhi. It spreads through contaminated food and water and is most common in areas with poor sanitation. While rare in the United States (about 350 cases annually, mostly in travelers), typhoid remains common in South Asia, Africa, Latin America, and other developing regions.

Untreated typhoid can be life-threatening, but it's preventable through vaccination and safe food/water practices. If you're traveling to high-risk areas, understanding symptoms and prevention is crucial.

Common Symptoms

Prolonged High Fever

Fever is the hallmark symptom, typically starting low and gradually increasing to 103-104°F (39-40°C) over several days. Unlike many infections, fever may persist for weeks without treatment.

Characteristics:

• Gradual onset over 3-4 days
• Sustained high fever (not intermittent)
• May last 3-4 weeks untreated
• Often worse in evening

Weakness and Fatigue

Extreme tiredness and weakness develop as the infection progresses, making even simple activities exhausting.

Signs:

• Profound fatigue
• Muscle weakness
• Difficulty performing daily tasks
• Feeling too weak to get out of bed

Digestive Symptoms

Abdominal pain, constipation (more common in adults), or diarrhea (more common in children) occur frequently.

Signs:

• Abdominal discomfort or pain
• Constipation or diarrhea
• Loss of appetite
• Nausea
• Bloating

Headache and Body Aches

Severe headache and generalized body aches accompany the fever.

Signs:

• Persistent headache
• Muscle aches
• Joint pain
• General malaise

Rose Spots Rash

Some people develop small, rose-colored spots on the trunk (chest and abdomen), though this is less common.

Characteristics:

• Small, flat, rose-colored spots
• Appear on trunk
• Develop in second week
• Not always present

When to See a Doctor

Seek immediate medical attention if:

• You develop fever after traveling to areas where typhoid is common
• Fever persists for more than 2-3 days
• You have severe abdominal pain or bloody stools
• You show signs of dehydration: extreme thirst, little urination, dizziness
• You experience confusion or altered mental status
• Symptoms worsen despite initial treatment

Typhoid requires antibiotic treatment—it won't resolve on its own. Early treatment prevents serious complications.

Complications

Untreated or severe typhoid can cause:

• Intestinal bleeding or perforation (life-threatening)
• Severe dehydration
• Kidney or liver problems
• Heart inflammation (myocarditis)
• Pneumonia
• Confusion or delirium
• Death (10-30% if untreated, less than 1% with treatment)

Treatment

Antibiotics

Typhoid requires antibiotic treatment, typically for 7-14 days. Common antibiotics include ciprofloxacin, azithromycin, or ceftriaxone. Complete the full course even if you feel better.

Supportive Care

Rest, adequate fluids, and nutrition support recovery. Hospitalization may be needed for severe cases or complications.

Isolation

Avoid preparing food for others until your doctor confirms you're no longer contagious (usually after completing antibiotics and having negative stool tests).

Frequently Asked Questions

Prevention Tips

If traveling to areas where typhoid is common, get vaccinated 1-2 weeks before departure. Practice strict food and water safety: drink only bottled or boiled water, avoid ice made from tap water, eat only thoroughly cooked hot foods, avoid raw fruits and vegetables unless you peel them yourself, avoid food from street vendors, and don't eat food that's been sitting at room temperature. Wash hands frequently with soap and water, especially before eating and after using the bathroom. Use hand sanitizer when soap isn't available. Avoid unpasteurized dairy products. Be cautious with seafood, especially shellfish. If you live in or frequently visit endemic areas, consider vaccination even if you're a resident. Ensure proper sanitation and sewage systems in your home. If you've had typhoid, get tested to ensure you're not a carrier before handling food for others. Educate yourself about typhoid risk in your destination before traveling—risk varies significantly by region and even by city.

The Bottom Line

Typhoid fever is a serious bacterial infection spread through contaminated food and water, most common in developing regions with poor sanitation. Symptoms include prolonged high fever (103-104°F), weakness, headache, abdominal pain, and digestive issues. While rare in the US, travelers to endemic areas are at risk. Typhoid requires antibiotic treatment and can cause life-threatening complications if untreated. Prevention includes vaccination before travel to high-risk areas and strict food/water safety practices: drink bottled or boiled water, eat thoroughly cooked foods, avoid raw produce you didn't peel yourself, and practice good hand hygiene. If you develop fever after traveling to areas where typhoid is common, seek medical attention immediately. With prompt antibiotic treatment, most people recover fully. Vaccination and safe practices are highly effective at preventing this potentially serious disease.