All You Need To Know About Typhoid!

Introduction

Typhoid is a bacterial infection caused by Salmonella typhi, a bacterium. It is typically characterised by high fever, nausea, vomiting, and, in some cases, diarrhoea. The disease is primarily transmitted through the consumption of food or water contaminated with faecal matter, making it more common in areas with inadequate sanitation and limited access to clean drinking water. If left untreated, typhoid can be fatal. However, with timely diagnosis and appropriate antibiotic treatment, most individuals make a full recovery. Improving hygiene and sanitation practices is key to preventing the spread of this potentially life-threatening illness.. 

Other serious complications include¹: 

• Pancreatitis 
• Hallucinations 
• Pneumonia 
• Bladder and kidney infection, to name a few. 

Common and more specific complications of typhoid include¹:  

• Intestinal perforation and bleeding (most serious) 
• Encephalopathy or delirium (more appropriate than hallucinations) 
• Hepatosplenomegaly 
• Sepsis or secondary infections 
• Pancreatitis and pneumonia are rarely direct complications, and kidney/bladder infections are not typically linked to typhoid. 

In many cases, individuals may carry Salmonella typhi without showing any noticeable symptoms, a condition known as being an asymptomatic carrier. These carriers can unknowingly contribute to the spread of the infection. Once symptoms become evident, such as persistent fever and gastrointestinal discomfort, a course of antibiotics is typically prescribed to manage the infection and help recovery². 

Other Forms of Treatment

In addition to antibiotic treatment, individuals diagnosed with typhoid are often advised to stay well-hydrated by consuming clean, preferably boiled water, and to practise strict food hygiene, such as thoroughly washing fruits and vegetables before consumption². 

During pregnancy, typhoid can lead to serious complications, including miscarriage, premature labour, intrauterine growth restriction (IUGR), and even faetal loss, largely due to systemic infection and high maternal fever³. Vaccination offers a significant degree of protection and is especially recommended for those living in or travelling to areas where typhoid is endemic. However, as no vaccine provides complete immunity, it must be complemented by good sanitation and hygiene practices to effectively prevent infection and limit its spread⁴. 

Vaccination

If an individual has not been exposed to the Salmonella typhi bacterium, typhoid vaccination is often recommended as a preventive measure. Doctors may prescribe the vaccine to those who are carriers of the disease, individuals in close contact with typhoid patients, or persons planning to travel to regions where typhoid fever is prevalent. The vaccine is available in two forms: an oral capsule (Ty21a) or a single-dose injection (Vi polysaccharide). However, the vaccine is preventive rather than therapeutic, meaning it does not treat active infections and is ineffective once illness has begun. It is also not suitable for very young children. The polysaccharide vaccine is approved for children aged two years and above, while the oral Ty21a vaccine is approved for those aged six years and older. In rare cases, the vaccine may cause mild side effects, including gastrointestinal discomfort, headache, or nausea, and should therefore be administered under medical supervision². 

Typhoid fever is an illness you get from S. Typhi bacterium. It causes a high fever, flu-like symptoms, and diarrhoea. You can be contagious with typhoid even if you don’t feel sick. Typhoid can be life-threatening and is usually treated promptly with antibiotics.

Dr. M.G. Kartheeka, MBBS, MD(Pediatrics)

Avoiding the Infection

To reduce the risk of contracting Salmonella typhi, it is advisable to follow these preventive practices, especially when travelling to or living in areas where typhoid is common⁵: 

• Avoid using ice in your beverages, as the water used to make ice may be contaminated. 
• Drink only boiled or filtered water at all times. 
• Refrain from consuming street food, which may be prepared in unhygienic conditions. 
• Choose freshly cooked, hot meals over raw or cold food items. 
• Be selective about where you eat; opt for well-reviewed and reputable establishments rather than trying unfamiliar food vendors. 
• Avoid eating raw fruits unless you peel them. If you do not wish to peel the skin, ensure the fruit is washed thoroughly with clean water. 
• Avoid popsicles and fountain drinks unless you are certain they are made using safe water. 
• Choose carbonated bottled water and check that the seal is intact before purchasing. 
• Consume only pasteurised dairy products and ensure eggs are hard-cooked. 
• Practise regular handwashing with soap and clean water, this is one of the most effective defences against typhoid and other enteric infections. 

Practice Hygiene

To minimise the risk of contracting or spreading typhoid, it is important to follow these essential personal hygiene practices⁶: 

• Before sitting to eat, wash your hands with an antiseptic soap. 
• Avoid direct contact with individuals who are unwell. 
• Wash your hands often and especially after using the toilet. 
• When travelling, increase your use of hand sanitiser and ensure the sanitiser contains at least 60% alcohol. 
• If you are unwell, do not prepare or serve food to others to prevent the risk of transmission. 

Conclusion

Typhoid is a serious but preventable bacterial infection that spreads through contaminated food and water. Maintaining good hygiene, following safe food and water practices, and considering vaccination where appropriate are key to prevention. With prompt medical attention and responsible habits, the risks associated with typhoid can be significantly reduced. 

Also Read: Typhoid Vaccine: What is It, Types, When to Be Taken & Side Effects

References

1. Bhandari J, Thada PK, DeVos E. Typhoid Fever [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2025 Jun 17]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557513/  
2. Kalra S, Naithani N, Mehta S, Swamy A. Current Trends in the Management of Typhoid Fever. Medical Journal Armed Forces India [Internet]. 2003 Apr [cited 2025 Jun 17];59(2):130–5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923770/  
3. Touchan F, Hall JD, Lee RV. Typhoid fever during pregnancy: case report and review. Obstetric Medicine [Internet]. 2009 Nov 30 [cited 2025 Jun 17];2(4):161–3. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4989662/  
4. Typhoid [Internet]. Who.int. 2019 [cited 2025 Jun 17]. Available from: https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/typhoid  
5. CDC. Preventing Typhoid Fever and Paratyphoid Fever [Internet]. Typhoid Fever and Paratyphoid Fever. 2024 [cited 2025 Jun 17]. Available from: https://www.cdc.gov/typhoid-fever/prevention/index.html  
6. Chen J, Long JE, Vannice K, Shewchuk T, Kumar S, A Duncan Steele, et al. Taking on Typhoid: Eliminating Typhoid Fever as a Global Health Problem. Open Forum Infectious Diseases [Internet]. 2023 May 1 [cited 2025 Jun 17];10(Supplement_1):S74–81. Available from: https://academic.oup.com/ofid/article/10/Supplement_1/S74/7188906  

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

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