Typhoid fever – Symptoms, causes and treatment

Typhoid fever is a bacterial infection that spreads through infected food or contaminated water. It is most common in Africa, Asia and South America and requires treatment in order not to be life threatening.

About twenty cases in Sweden are usually reported every year, and they are almost exclusively infected abroad. The bacterium that causes typhoid fever is called Salmonella Typhi. Typhoid fever and similar parathyroid fever are infectious traceable diseases. This means that infections that occur in Sweden need to be reported to the authorities by the treating physician.

Only people can be affected

Although the name of the bacterium contains “salmonella”, typhoid fever is usually not included when talking about salmonella. The reason is that typhoid fever is a type of blood poisoning (sepsis). Unlike salmonella, typhoid fever can only affect people. Typhoid fever used to be called “nerve fever” in Sweden. The disease was common in Sweden during the 19th century and the early 1900’s.

Symptoms of typhoid fever

Some symptoms of typhoid fever are:

  • Prolonged high fever
  • Muscle pain and headache
  • Constipation and subsequent diarrhea
  • Fatigue and confusion
  • Loss of appetite
  • Pale red rash on the body

Typhoid fever has an incubation period (time between infection and disease outbreak) of 10 to 14 days. The incubation period and the course of the disease vary depending on the amount of bacteria gained during the infection. High fever despite slow pulse in combination with the pale red rashes on the abdomen are common signs. Typical of the stomach ailments is that they begin with a constipation which then becomes diarrhea.
Allowing the symptoms to continue without seeking care can cause bleeding ulcers in the gastrointestinal tract, which can then develop into peritonitis, a life-threatening condition.

Causes of typhoid fever

Hygiene and cleanliness are the main causes of the spread of typhoid fever. The prevalence of typhoid fever in, for example, Europe, has decreased as hygiene has improved in industrial society. The infection usually occurs by eating or drinking something that has come into contact with contaminated water.

Typhoid fever can also be transmitted from person to person because a very small amount of bacteria is required to get the disease. Normally you are infected for four to six weeks, but there are also carriers that have had the infection for years or even as a lifelong infection.

Where is typhoid fever?

Typhoid fever is found worldwide, but it is very uncommon in Europe, North America and Australia. Countries in Asia such as India, Bangladesh and China as well as the majority of Africa and South America are counted as risk areas. Those who seek treatment for typhoid fever in, for example, Sweden have usually become infected abroad. If the infection against presumption has occurred in Sweden, there is often someone who has carried on typhoid fever without symptoms and cooked for the infected.


Diagnosis of typhoid fever is most often determined via blood tests, as the bacterium appears in the blood early in the course of the disease. If you have had the bacterium for a little longer (about two weeks) it can also be found in feces and urine.

Treatment of typhoid fever

Typhoid fever is treated with antibiotics. Since the disease is seen as serious, you are often hospitalized during the course of the procedure. If you treat typhoid fever in Sweden, however, you usually get completely healthy. Also worth noting is that infectious carriers who have not or no longer have any symptoms should be treated with antibiotics to avoid infecting others.

Everyone in Sweden who carries typhoid fever is checked until it is found that the infection is gone. If you work with food you cannot work until the typhoid fever has disappeared.

Untreated typhoid fever is dangerous as the mortality rate of the disease is relatively high. Complications such as bleeding, peritonitis, and intestinal distention may occur. Most people who receive treatment in good time get better within a few days after the antibiotic has been used.


Since the spread of typhoid fever is linked to hygiene, you should have good kitchen and hand hygiene to prevent infection, especially when traveling in affected areas:

  • Wash your hands with soap frequently, especially before meals or after a toilet
  • Do not drink tap water or water from an unsafe source. Keep in mind that ice in beverages can be of contaminated water and transmit typhoid fever
  • Avoid fruits and vegetables that do not have peel
  • Eat warm food that has not stood at room temperature any longer
  • Carry antibacterial hand spirit with you if you need to clean your hands in a place where there is no soap

Don’t forget that the bacteria can remain and secrete infection for four to six weeks after being healed. Do not handle food served to other people during your recovery.

Vaccination – good to have but not a guarantee

There is vaccination against typhoid fever. It is taken either as a tablet or by getting a syringe. Vaccination is recommended if you travel to countries where the disease occurs for over three weeks, if you have plans to live with the local population or eat at simple eateries outside of tourist areas. Worth knowing about the vaccines is that they have about 50 to 80 percent protective effect. Thus, being vaccinated is not a reason not to maintain good hygiene while traveling.

When should you seek care?

Seek immediate care if you have a high fever in countries where the infection is common. The same applies if you suspect you have typhoid fever or if you have suffered from a high fever after coming home from a trip abroad from a part of the world where typhoid fever occurs.

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