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by Badash M
(Enteric Fever; Paratyphoid Fever)


Typhoid and paratyphoid fevers are infections from bacteria.


Certain bacteria cause the infection. You get it through contact with fluids from the body of a person who is sick. Some people don’t get sick. They can still pass it to others. The bacteria also pass to you when you use food or drinks tainted with sewage.

Digestive System
Small intestines
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Risk Factors

Typhoid is common in places with poor sanitation. The risk of getting sick is highest in parts of India, Africa, and Asia.

Risk is also higher if you have:

  • Contact with body fluids
  • Food or drink tainted by sewage
  • Low amounts of stomach acid—can happen when you take acid reducers


Symptoms range from mild to severe.


  • Low fever
  • Headache
  • Constipation —more common in adults
  • Diarrhea —more common in children
  • Rash of rose-colored spots
  • A coating on your tongue
  • Lack of hunger


  • High fever and chills—may last a long time
  • Belly pain
  • Changes in your mental state


The doctor will ask about your symptoms. You will be asked about your health and travel history. A physical exam may point to typhoid. If needed, you may also have:


Care will start right away, even if your test results aren’t ready. Antibiotics treat the infection. You may also need:

  • Rehydration—may be given through an IV or by mouth
  • Medicines to lower fever or ease pain
  • Surgery to remove the gallbladder —for people who carry typhoid (not common)


When you travel to places where typhoid is common:

  • Talk to your doctor about getting the vaccine before you leave.
  • Don’t use local water unless you know it’s safe.
  • Eat foods that are cooked through and hot.
  • Don’t eat raw or undercooked shellfish.
  • Don’t eat raw fruits or vegetables that don’t have a peel.
  • Don’t eat or drink unpasteurized dairy.


Centers for Disease Control and Prevention  https://www.cdc.gov 

World Health Organization  http://www.who.int 


Public Health Agency of Canada  https://www.canada.ca 

Travel and Tourism—Government of Canada  https://travel.gc.ca 


Bhan MK, Bahl R, Bhatnagar S. Typhoid and paratyphoid fever. Lancet. 2005;366(9487):749-762.

Bui YG, Trépanier S, Milord F, et al. Cases of malaria, hepatitis A, and typhoid fever Among VFRs, Quebec (Canada). J Travel Med. 2011;18(6):373-378.

Enteric fever (typhoid and paratyphoid fever). EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T114546/Enteric-fever-typhoid-and-paratyphoid-fever  . Updated February 5, 2018. Accessed May 24, 2018.

Johnson KJ, Gallagher NM, Mintz ED, et al. From the CDC: new country-specific recommendations for pre-travel typhoid vaccination. J Travel Med. 2011;18(6):430-433.

Typhoid fever. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/typhoid-fever/index.html. Updated July 18, 2016. Accessed May 24, 2018.

Typhoid fever. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/infectious-diseases/gram-negative-bacilli/typhoid-fever. Updated April 2018. Accessed May 24, 2018.

Typhoid VIS. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/vaccines/hcp/vis/vis-statements/typhoid.html. Updated June 18, 2013. Accessed May 24, 2018.

Revision Information