Typhoid fever is an illness caused by Salmonella Typhi (S. Typhi) bacteria that infects the intestinal tract and the blood.
Salmonella Typhi (S. Typhi) are bacteria which infect the intestinal tract and the blood. The disease is called typhoid fever. Salmonella Paratyphi A, B and C (S. Paratyphi) bacteria cause a similar illness called paratyphoid fever. Paratyphoid fever is generally milder and shorter in duration than typhoid fever.
S. Typhi and S. Paratyphi are common in many countries where sewage and water treatment systems are poor. Most cases reported in BC are travellers returning from international travel.
A S. Typhi infection is serious and potentially life-threatening.
Symptoms may include:
- Constipation, more common than diarrhea
- High fever
- Headache
- Fatigue
- Loss of appetite
- Dizziness
- Cough
- A rash on the abdomen (belly) or chest
Symptoms start an average of one to two weeks after exposure to the bacteria. However, some people may get sick in as little as three days, and others may take more than 60 days to develop symptoms.
If you think you have a S. Typhi infection, see your doctor or healthcare provider for testing, advice and treatment.
S. Typhi is spread when you drink water or eat food that is contaminated by the bacteria, from feces or urine of people with typhoid fever and carriers (a carrier is someone who has recovered from illness but continues to carry the bacteria in their body and can infect others). For example, transmission may happen from:
- Consuming contaminated food or drink, prepared by someone who is infected or a carrier,
- Contact with the feces of a person with typhoid fever without proper hand washing, or
- Consuming ready-to-eat food that has been contaminated by sewage, such as fruit fertilized with untreated human waste (night soil), or shellfish from an area contaminated by a sewer outfall
People can continue to infect others even after symptoms have stopped. Some people continue to spread the bacteria after recovering from the illness (about 10% of those recovered pass the bacteria in their stools or urine for up to three months). 2 to 5% of people ill with typhoid may become carriers (a smaller number with paratyphoid become carriers), passing the bacteria in their stools or urine for long periods.
With treatment, the risk of death is very low (<1%). However, 10-25% of people may experience a recurrence of illness.
A doctor can test for a S. Typhi infection in the blood or stool.
Early treatment with antibiotics reduces the risk of serious illness or death. Without antibiotic treatment, symptoms may last for months, and the risk of death be as high as 20%.
Your doctor will help decide which treatment is right for you.
If you are sick from typhoid fever, you should drink plenty of fluids to prevent dehydration (loss of fluids).
If you are a food handler, health care worker or work in or attend a day care, it is possible to transmit S. Typhi or S. Paratyphi to others in these settings. You must not work while infected. A public health official will contact you to discuss when you can return to work or day care.
Children in day care with fever or diarrhea can be cared for temporarily in an area separate from other children until picked up by their parents. To ensure proper hand washing, children should be supervised by an adult when washing their hands.
Before you travel to a country where S. Typhi is common, talk to a health care provider or a travel clinic to discuss vaccination. It may be recommended that you get the typhoid vaccine. For more information on the vaccine visit
HealthLinkBC.
Anyone who travels to a country where typhoid fever is common, including Canadian immigrants returning to their country of origin, is at risk of becoming infected with S. Typhi. It is important to wash your hands often and be aware of the foods you eat and where you buy them.
The following tips can help you avoid infection:
- Wash your hands with clean water after using the toilet, before preparing food or drink and before eating
- Drinking water must be bottled (commercially sealed bottle) or boiled
- Avoid drinks served with ice unless you are certain the ice was made from bottled or boiled water
- Do no eat raw fruits and vegetables unless you can peel them yourself
- Do not consume raw or undercooked fish or shellfish, especially oysters.
- Food should be well cooked and served hot
- Do not eat food from street vendors
- Do not consume unpasteurized dairy products (milk, cheese, yogurt)
