Typhoid Fever: Causes, Tests, Treatment and Prevention

6 min read · Conditions · By the Asthra Health Care team

What is typhoid?

Typhoid fever, also called enteric fever, is caused by the bacteria Salmonella Typhi. A similar but usually milder illness, paratyphoid, is caused by related bacteria. These bacteria live only in humans and spread when food or water is contaminated by the stools of an infected person.

Typhoid is common in places with unsafe drinking water and poor sanitation. It is seen more often in the monsoon and summer, and from street food, cut fruits, unboiled water and ice made from unsafe water. Flooding during heavy rains can mix sewage with drinking water pipes, which is why cases often rise after the rains.

Symptoms of typhoid fever

Symptoms begin one to three weeks after infection. Typically, the fever rises slowly over several days and stays high. Without treatment, the illness can last weeks and become serious. Some people recover but continue to carry the bacteria and can spread it without feeling ill.

• Fever that rises step by step and stays high
• Headache, weakness and body ache
• Stomach pain and loss of appetite
• Constipation or loose motions
• Dry cough
• Sometimes faint rose-coloured spots on the chest or stomach

Possible complications

If typhoid is not treated properly, it can lead to serious problems in the second or third week, such as bleeding in the intestine or a hole (perforation) in the bowel, which causes sudden severe stomach pain. It can also affect the liver, heart and brain. Early diagnosis and correct treatment greatly lower these risks.

A small number of people become long-term carriers after recovery. They feel well but pass the bacteria in their stools and can infect others, especially if they handle food. If you work as a cook or food handler, ask your doctor whether follow-up stool tests are needed.

Tests for typhoid

A blood culture is the most reliable test, especially in the first week of fever. It also helps the doctor choose an antibiotic that will work, because drug resistance in typhoid is a growing problem in India. Stool and urine cultures may help later in the illness.

The Widal test is widely used but can give misleading results, particularly early in the illness or in people who had typhoid or the vaccine before. Your doctor will interpret any test result together with your symptoms, and may also order a complete blood count and liver tests.

How typhoid fever is treated

Typhoid is treated with antibiotics, taken only on a doctor's prescription. The choice depends on local resistance patterns, culture results and how unwell the person is. Severe cases may need hospital care and injectable antibiotics. Fever often takes several days to settle even with the right medicine, so do not change antibiotics on your own if you do not feel better at once.

Do not take leftover antibiotics or start a course on your own. Wrong or incomplete antibiotic use is a major reason typhoid bacteria have become resistant. Take the full course exactly as prescribed, even if the fever settles in a few days, and go back to the doctor if fever continues.

Diet and home care

Rest well and drink plenty of safe fluids such as boiled water, oral rehydration solution, soups and buttermilk. Eat soft, easily digested food: rice gruel, khichdi, idli, curd rice, boiled vegetables and bananas. Small frequent meals are easier than large ones. There is no need to stop eating; good nutrition helps recovery.

Paracetamol can relieve fever and headache; follow the label or your pharmacist's advice. Pregnant women, young children, the elderly and people with other illnesses should be seen by a doctor early. Weakness and poor appetite can last some weeks after typhoid, so return to work and heavy activity gradually.

Preventing typhoid fever

Drink boiled or properly purified water. Wash hands with soap after using the toilet and before cooking or eating. Eat freshly cooked hot food and avoid raw salads, cut fruits and ice from roadside stalls. People who have had typhoid should not cook for others until their doctor confirms they are clear.

Typhoid conjugate vaccines are available for children and adults and are recommended in India. Vaccination is especially useful for children, travellers and people who often eat outside. Ask your doctor or pharmacist whether the vaccine is right for you and your family.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.