What are the main symptoms or signs of Typhoid fever: a slow fever from contaminated food and water?

Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.

When should you see a doctor for Typhoid fever: a slow fever from contaminated food and water?

See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.

Infectious Diseases

Typhoid fever: a slow fever from contaminated food and water

Not a simple gastroenteritis

Dr. Yanis Kaddour

Infectious disease specialist

6 min read

Medical illustration of Typhoid fever: a slow fever from contaminated food and water

In simple terms

The stepwise fever, why diagnosis needs blood cultures, and treatment in an era of resistance.

What it is, in plain words

Typhoid is caused by Salmonella Typhi, swallowed in contaminated food or water. Unlike ordinary food poisoning, the bacteria cross the gut wall and circulate in the bloodstream, which is why the illness is a prolonged fever rather than a short bout of diarrhoea.

Signs to look out for

Fever rising in steps over several days, reaching 39 to 40 C
Severe headache, marked fatigue and loss of appetite
Abdominal pain, constipation more often than diarrhoea in adults
Relatively slow pulse for the level of fever, and faint pink spots on the trunk
Third week complications: intestinal bleeding or perforation, confusion

Why it happens

Risk is highest with travel to South Asia, Africa and parts of Latin America, and with eating street food, salads washed in untreated water, ice and unpeeled fruit.

How doctors confirm it

Blood cultures are the reference test and should be taken before antibiotics; stool and bone marrow cultures add sensitivity. The old Widal test is unreliable and should not guide treatment alone.

Treatments and solutions

Antibiotics guided by local resistance patterns, commonly azithromycin or a third-generation cephalosporin, since resistance to older drugs is widespread
Continuing treatment for the full course, usually seven to fourteen days, even when fever settles slowly over three to five days
Rehydration, nutrition and paracetamol for fever
Corticosteroids in severe cases with confusion or shock, and surgery for perforation
Stool testing after recovery in food handlers, since some people become long-term carriers

Living with it day to day

Prevention when travelling: vaccination, drink sealed or boiled water, avoid ice, eat food that is cooked and still hot, peel fruit yourself, and wash hands before eating.

When to seek medical help

Seek urgent care for severe abdominal pain, black or bloody stools, confusion, or a fever lasting more than three days after travel.

This article explains general health information in simple language. It does not replace advice from your own doctor.

The words explained

Medical terms used above, in everyday language.

Antibiotic: A medicine that kills bacteria. It does not work against viruses like colds or flu.
Prevention: Steps taken before a problem starts, to make it less likely.
Vaccine: A safe training session for your immune system, so it can fight a germ later.

When should you see a doctor?

Your symptoms last more than a few weeks or keep coming back.
They get worse quickly, or stop you doing everyday things.
You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
You already take medication and want to change anything about it.

This article explains general health information. It does not replace advice from your own doctor.

Frequently asked questions

What is Typhoid fever: a slow fever from contaminated food and water?: The stepwise fever, why diagnosis needs blood cultures, and treatment in an era of resistance.
What are the main symptoms or signs of Typhoid fever: a slow fever from contaminated food and water?: Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
When should you see a doctor for Typhoid fever: a slow fever from contaminated food and water?: See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.

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