Planning an exotic vacation? If you are, familiarize yourself with diseases that are common in other parts of the world even though they may be rare in the United States. Typhoid fever is one such illness. Although not often encountered in the US, this disease affects around 21.5 million people in developing parts of the world each year. And around 75% of the cases that do occur in the US are picked up during international travel.1
Initial signs of this condition can include a general feeling of being ill, abdominal pain, and fever. As the illness gets worse, you may have a temperature of 103°F or higher and severe diarrhea. You may also experience chills, confusion, hallucinations, mood swings, fatigue, nosebleeds, blood in your stool, and red spots on your stomach and chest.2
What Causes Typhoid?
Infection by a kind of bacteria known as Salmonella typhi causes typhoid. These are different from the bacteria that cause salmonella food poisoning though they are related.3
How Does Typhoid Spread?
Salmonella typhi is present in your intestinal tract and bloodstream when you have typhoid. The bacteria are then shed in your stools. Unclean or contaminated hands do the rest of the job. If you don’t wash your hands properly after using the toilet, it can contaminate food handled by you. Anybody who eats this contaminated food also gets infected.4
Salmonella typhi can also be passed on through the urine of a person who’s infected. But this is less common.
In places where sanitation is poor, the water supply may also be contaminated with sewage or fecal matter and you may ingest the bacteria if you use this water for washing food items or if you drink it straight from the tap. Drink bottled water or boil tap water for at least a minute before drinking it. Also, if you use ice in your drinks, make sure that it’s made with clean water. Steer clear of popsicles unless you are certain that they’re not contaminated.5
Contaminated food is a common route for the spread of typhoid. Having sea food from a source of contaminated water, uncooked vegetables which have been fertilized with human excrement, food which has been cleaned in infected water, or food handled by someone who carries the infection can put you at risk. It’s best to limit yourself to foods which have been cooked thoroughly and are still hot. Avoid raw fruits and vegetables which can’t be peeled in risk-prone areas. When you do have fruits and vegetables which can be peeled, peel them yourself after washing your hands. Also, avoid food sold by street vendors as it can be tough to keep them clean.6
Sex With An Infected Person
Oral or anal sex with someone who’s carrying Salmonella typhi can result in your catching the infection.7
Other Risk Factors
Infection spreads rapidly: Once Salmonella typhi is consumed it gets into the digestive system, where it multiplies quickly. This triggers the symptoms of this illness. If not treated properly with antibiotics, typhoid can then spread to your bloodstream, from where it can infect other parts of your body. Organ and tissues may then get damaged, resulting in serious complications and even death.8
Carriers may not show symptoms: It’s also important to keep in mind that even people who don’t seem sick can spread this infection. In fact, up to 5% of patients who survive a typhoid fever without proper treatment are thought to become carriers. Although they don’t show any symptoms, the bacteria continue to live within them and can be spread through their feces or urine.9
The most well-known case of an asymptomatic carrier is Mary Mallon, who was nicknamed “Typhoid Mary.” She worked as a cook and is thought to have been responsible for infecting at least 122 people in the United States in the early part of the 20th century.10 And that’s why, if you contract typhoid fever and your work involves handling food or caring for children, you may be legally barred from working till a doctor certifies that you are free of Salmonella Typhi.11
How To Protect Yourself
Typhoid fever is commonly found in developing parts of the world, including Southeast and East Asia, the Caribbean, Africa, and South and Central America. Therefore, it makes sense to take precautions if you’re traveling to these areas. Speak to your doctor to find out if you should get vaccinated. However, do keep in mind that it’s important to control the risk factors mentioned earlier even if you’ve been vaccinated because the vaccines are not effective 100 percent of the time.12
What To Do If You Have Symptoms
Do get your blood or stool tested if you have symptoms of typhoid. This is the only way to determine if you have this illness. Antibiotics are used to treat typhoid fever. Without proper treatment, typhoid can kill up to 20% of people who are infected. And remember that even if your symptoms have gone away, you could still be carrying the bacteria. So it’s important to complete the course of medicine that’s prescribed.
Minimize spreading the infection by washing your hands thoroughly after using the bathroom. Also avoid handling food consumed by others to lower the risk of passing on the infection.
Once treatment is completed your doctor can perform tests to determine that the infection has been completely cleared from your body.13
|↑1, ↑5, ↑6, ↑12||Typhoid Fever. Centers for Disease Control and Prevention.|
|↑2||Typhoid fever. National Institutes of Health.|
|↑3, ↑4, ↑7, ↑9||Typhoid fever – Causes. National Health Service.|
|↑8||Typhoid Fever. Centers for Disease Control and Prevention.|
|↑10||Marineli, Filio, Gregory Tsoucalas, Marianna Karamanou, and George Androutsos. “Mary Mallon (1869-1938) and the history of typhoid fever.” Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology 26, no. 2 (2013): 132.|
|↑11||Typhoid Fever. Centers for Disease Control and Prevention|
|↑13||Typhoid Fever. Centers for Disease Control and Prevention.|