Typhoid Fever

What is it?
Typhoid fever is a bacterial illness caused by
Salmonella Typhi (S-Typhi), one type of the
Salmonella bacteria group. This disease is not to be
confused with Salmonella food poisoning caused by
the other members of the Salmonella group (nontyphi Salmonella).
How can your child get it?
S.Typhi bacteria live only in humans. Persons who are ill with Typhoid fever carry the bacteria
in their blood and intestinal tract. A small number of those who recover from the disease
continue to carry and pass the bacteria to others, even though they are not ill with the disease.
The bacteria must enter the body through the mouth to cause disease. Your child can get typhoid
fever if your child eats food or drinks beverages that have been handled by persons passing S.
Typhi in their feces or if sewage contaminated with S. Typhi bacteria gets into the water you use
for drinking or washing food. Large epidemics are most often related to the contamination of
water supplies or street vended foods.
What are the signs and symptoms of Typhoid Fever?
Once S. Typhi bacteria get into the body, the bacteria multiply and spread into the blood causing
a sustained fever as high as 39 to 40 C. The fever may take few days and up to 3 months to
occur. Your child may feel weak, or have stomach pain, headache, or loss of appetite. Your child
may also have a rash of flat, rose-colored spots usually over the belly or chest.
The only way to know for sure if an illness is typhoid fever is to have samples of stool or blood
tested for the presence of the bacteria that cause the disease (S. Typhi).
What should you do?
1. If you think your child has Typhoid fever take him/her to see the doctor immediately
2. Medications:
Your child will probably be given antibiotics to treat the disease.
Your child should take the antibiotics exactly as prescribed by the doctor. Persons
given antibiotics usually begin to feel better within 5 to 7 days. However, persons
who do not get treatment may continue to have fever for weeks or months, and as
many as 20% may die from complications of the infection.

2011 American University of Beirut Medical Center

3. Diet:
Make sure your child eats a well-balanced diet.
Make sure that your child drinks enough fluids to maintain adequate hydration.
4. Activity:
Allow your child to play and be active as much as he/she can tolerate.
5. Hygiene:
Teach your child to wash his/her hands carefully with soap
and water after using the bathroom.
Do not let your child prepare or handle food that will be
served to other people to lower the chance of passing the
infection on to someone else.
6. Considerations:
Even if you feel that your child is getting better and the symptoms seem to have
gone away, your child may still be carrying the bacteria. If so, the illness can
recur, or your child may pass the disease to other people. Your doctor will request
a series of stool cultures to ensure that no bacteria remain in your childs body.
How can you avoid typhoid fever?
Typhoid fever is more common in areas where hand washing is less frequent and water is likely
to be contaminated with sewage. If your child is in such areas, there are basic steps you can
follow that can protect you and your child from typhoid fever
1.

Boil it, cook it, peel it, or forget it"

Make sure your child drinks bottled water or water that has been boiled for 1
minute. Bottled carbonated water is safer than uncarbonated water.
Makes sure your child does not have drinks with ice unless the ice is made from
bottled or boiled water. Make sure your child avoids popsicles and flavored ices
that may have been made with contaminated water.
Make sure your child eats food that have been thoroughly cooked and that are still
hot and steaming.
Makes sure that your child avoids raw vegetables and fruits that cannot be peeled.
Vegetables like lettuce are easily contaminated and are very hard to wash well.
When your child eats raw fruit or vegetables that can be peeled, make sure that
you peel them yourself. (Wash your hands with soap first.) Do not let your child
eat the peelings.
Make sure your child avoid food and beverages from street vendors. It is difficult
for food to be kept clean on the street, and many travelers get sick from food
bought from street vendors

2011 American University of Beirut Medical Center

2. Get your child vaccinated against typhoid fever. If your child is traveling to a country
where typhoid is common, you should consider having him/her vaccinated against
typhoid. Vaccination should be completed at least 1 week before travel so that the
vaccine has time to work. Typhoid vaccines lose effectiveness after several years; if your
child was vaccinated in the past, check with his/her doctor to see if it is time for a booster
vaccination. Taking antibiotics will not prevent typhoid fever; they only help treat it.
Vaccines alone are not completely effective. It is of utmost importance to avoid risky foods
which will also help protect your child from other illnesses, including travelers' diarrhea, cholera,
dysentery, and hepatitis A.

Prepared By:
Samer I. Masri, MD, PGYIII
Reviewed and edited by:
Mariam Kayle, RN, MSN, CCNS, Pediatric Advanced Practice Nurse
Rima Wakim, MD, Instructor, General Pediatrics, Pediatric Infectious Diseases

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/typhoidfever_g.htm
http://edis.ifas.ufl.edu/fs125
http://www.state.nj.us/health/cd/manual/typhoid.pdf

2011 American University of Beirut Medical Center