Typhoid: Everything You Need to Know About This Infectious Disease

Typhoid, also known as typhoid fever, is an infection caused by the Salmonella typhi bacterium. The infection is life-threatening and typically spread through contaminated water or food. That said, person-to-person transmission is also possible. 

Once in the body, the bacteria multiply and spread through the bloodstream, causing symptoms including fever, gastrointestinal distress, and headache. Without early treatment using antibiotics, typhoid can cause severe health complications and death.

Typhoid is most common in Southern Asia, Western Pacific regions, Central and South America, the Caribbean, Africa, and other areas without access to safe water and sanitation practices.

According to the Centers for Disease Control and Prevention (CDC), roughly 157 cases of typhoid occurred in the United States in 2020.

This article discusses the transmission of the bacteria that causes typhoid, symptoms, risk factors, and treatment for typhoid.

How Is Typhoid Transmitted?

The primary transmission method for typhoid is consuming water or food contaminated with the Salmonella typhi bacterium. Water and food can become contaminated with the bacterium through:

• Improper sanitation practices
• Improper drainage systems
• Scarcity of clean water

Typhoid vs. Typhus 

Typhoid and typhus may sound similar, but the two infections are caused by different types of bacteria. The spread of infection in both typhoid and typhus also differs.

For example, unlike typhoid, which is primarily spread through contaminated water and food, in the United States, typhus is typically spread through fleas that contract it from animals, such as rats and opossums.

Typhoid Symptoms

There are various symptoms associated with a typhoid infection. They can include:

• High fever
• Abdominal pain
• Diarrhea
• Headache
• Nausea
• Constipation
• Rash, in some cases

These symptoms can be either mild or severe. If the infection is left untreated, it can progress into worsened symptoms and severe health complications that can be fatal.

What Causes Typhoid?

Typhoid is caused by the Salmonella typhi bacterium. The bacterium gets into the water supply via feces in places with inadequate sanitation and drainage practices.

Salmonella typhi can pass to humans in the following ways:

• Drinking water that is not adequately purified
• Eating food that has been irrigated with contaminated water
• Eating food that was handled by someone with the bacterium on their hands

Feces containing the bacterium can also get onto raw meat and poultry during the butchering process, spreading the infection.

Who Is at Risk for Typhoid?

Those living in areas with poor sanitation practices and a lack of access to clean water are most likely to contract the bacterium that causes typhoid.

Children are considered more at risk than adults because their immune systems have yet to be fully developed. However, children often experience less severe symptoms if they do have typhoid.

Adults with weakened immune systems are the most at risk for severe illness and life-threatening typhoid complications.

How Typhoid Is Diagnosed

To diagnose typhoid, samples of blood, feces, or urine are taken. These samples will be examined microscopically to detect the presence of Salmonella typhi.

In some cases, repeat testing will be needed for confirmation, as the bacterium isn’t always detected during the first round of testing.

A sample of bone marrow may also be used to diagnose typhoid, as it’s one of the most accurate ways to detect the bacterium within the body. Typically, though, due to the painful and time-consuming nature of a bone marrow test, it is reserved for cases in which other tests are not conclusive.

How Typhoid Is Treated

The primary treatment for typhoid is antibiotics, which fight bacterial infections. This is the most effective method since it is a bacterium causing the infection. Because antibiotic resistance (when pathogens such as bacteria develop defenses against antibiotics) continues to be a global threat, stronger antibiotics may be required.

To ensure that the medication works as intended, people with typhoid must follow these rules during treatment:

• Take the antibiotics as prescribed, even if you start to feel better.
• Wash hands with soap and water after using the bathroom, and avoid preparing or serving food while you have a typhoid infection.
• Have a follow-up test to ensure that the bacterium is out of your system.

How to Prevent Typhoid

There are a few ways you can help prevent the spread of typhoid.

The first involves proper hygiene practices, such as washing hands after using the bathroom and before handling food.

Typhoid vaccination can prevent typhoid fever. Vaccination is recommended for those traveling to areas where typhoid is prevalent.

Typhoid Vaccine

Several vaccines are available for people who wish to reduce their risk of contracting typhoid. The vaccine given is based on factors such as their age.

The most common vaccine, known as a conjugate vaccine, contains a purified version of Vi antigen and is given in a single dose. It can be given to children as young as 6 months and adults up to age 65. A live attenuated oral vaccine is also available in capsule form for people aged 6 or above.

Avoiding Infection

Other ways to avoid a typhoid infection include:

• Only eat food that has been properly cooked and is still hot when served to you.
• Avoid raw milk products.
• Do not add ice to drinks unless you know it is made from safe water.
• Boil questionable water or disinfect it with a slow-release disinfectant agent before consuming.
• Practice good handwashing practices, especially after coming into contact with pets, farm animals or after using the washroom.
• Wash all produce carefully and peel when possible.

Typhoid and Travel

For those who live in developed countries, the risk of contracting typhoid is highest during travel. This is because many popular travel destinations fall into the high-risk categories of poor sanitation practices.

Those who visit family and friends in underdeveloped areas, as opposed to resorts and other tourist spots, are the most at risk for travel-induced typhoid because they are more likely to consume local foods and be exposed to unsafe water.

Can Typhoid Fever Cause Complications?

Many severe complications can arise after a person contracts typhoid, all of which can be fatal. Some complications are:

• Intestinal perforation
• Gastrointestinal bleeding
• Inflammation of the heart
• Redness and inflammation of the gallbladder
• Liver inflammation
• Kidney injury
• Pneumonia
• Brain illness (encephalopathy)
• Anemia
• Abnormal blood-clotting

Summary

Typhoid, or typhoid fever, is a bacterial infection caused by the Salmonella typhi bacterium. Anyone can contract the bacterium, especially if they live or travel to areas with poor sanitation and sewage practices and lack access to clean water.

The infection and its symptoms, such as a high fever, diarrhea, and headache, can be treated with antibiotics. Since typhoid can be life-threatening, it’s essential to take precautions and seek prompt medical treatment if you contract the bacterium.