Typhoid fever is caused by Salmonella typhi and can be fatal in severe cases. You may contract typhoid fever by ingesting food and beverages contaminated with the patient’s feces. Typhoid fever is very common in developing countries where hygiene (such as frequent handwashing) is low and clean water is scarce. Most people with typhoid fever get sick while traveling to other countries.

Recognize the Symptoms of Typhoid Fever

Check for fever. Early symptoms of typhoid include a persistently high fever of 103-104 degrees Fahrenheit (39-40 degrees Celsius). Typically, symptoms of typhoid fever appear 1-3 weeks after infection.

Secondary symptom check. Other symptoms of typhoid fever include headache, general malaise, fatigue, stomach pain, constipation, diarrhea, vomiting, and loss of appetite.

• Some patients will develop a large number of round, light pink rashes and an abnormally slow heartbeat, with the heart rate less than 60 beats per minute.

Go to the doctor. If you have a high fever and feel unwell, see your doctor right away. Remember that typhoid fever can be fatal if left unchecked, with up to 20% of patients dying from complications caused by typhoid fever.

• If you feel unwell and may have typhoid fever, be sure to avoid contact with others. Additionally, you should not prepare or serve meals to others.
• If you are traveling, you can usually contact your country’s consulate and ask them for a list of doctors (who should speak Chinese).
• Your doctor will perform a clinical analysis of your stool and blood samples for typhi bacteria to confirm the diagnosis.
• In some areas where labs are lacking or test results may be delayed, doctors may check the size of the liver and spleen by pressing and tapping the stomach. Enlargement of the liver and spleen are usually the “definite” symptoms of typhoid fever.
• Confirming this diagnosis is important because fever and other symptoms of typhoid are often similar to those of dengue fever, malaria, and cholera, which are common in developing areas.

Prevent Typhoid Fever

Avoid getting diseases through the mouth during travel. If you are traveling to a place where you are at risk of contracting typhoid fever, an important way to protect yourself is to avoid certain foods and certain cooking methods. To avoid consuming unclean food, follow these precautions:

• Eat foods that are fully cooked and steaming hot. High temperatures can kill bacteria.
• Avoid eating raw fruits and vegetables and vegetables without their skins. For example, lettuce is easily contaminated because its leaves are too large and difficult to wash thoroughly. Lettuce leaves have too many edges and corners, which can easily trap dirt and grime.
• If you crave fresh food, peel and wash the fruits and vegetables yourself. First, wash your hands with hot soapy water, and then make sure not to eat any fruit or vegetable peels.

Watch your drinking water. Make sure drinking water comes from a clean and uncontaminated place. Please follow these guidelines:

• Make sure to drink water from a sealed bottle or boil bottled water for one minute before drinking. Generally speaking, soda water is safer and more reliable than ordinary water.
• Even ice can be contaminated, so either avoid eating it or make sure the water used to make the ice comes from bottled or boiled water. Try to avoid any food made with water, such as popsicles and ice cream, which may be made with contaminated water.

Avoid eating food and drinks sold by roadside vendors. It is difficult to keep food on the roadside clean and hygienic. In fact many tourists report feeling ill after eating food purchased from roadside vendors.

Pay attention to personal hygiene. You should wash your hands frequently. If water and soap are not available around you, you should use a water-free hand sanitizer that contains at least 60% alcohol. Do not touch your face with unclean hands. You agree that close contact with sick people (including sharing cutlery, teacups, kissing, and hugging) should be avoided.

A helpful mantra to remember, learn this one devised by the Centers for Disease Control and Prevention: “Boil it, cook it, peel it, or don’t eat it!” If you’re still doubting whether you should eat it, consider this mantra. Remember it’s better to be careful beforehand than regret later!

Get vaccinated before you travel. If you plan to travel to developing countries where typhoid infection is likely, especially in Asia, Latin America, and Africa, you should include vaccination in your plans before traveling. Go to your doctor or nearby clinic to get vaccinated and ask if the typhoid vaccine is right for you. Keep in mind that if you’ve had a typhoid vaccine before, you still need to talk to your doctor to make sure you don’t need a booster shot. Typically, the typhoid vaccine becomes ineffective after a few years.

• There are two main types of injury vaccines available in the United States. One is a capsule vaccine. This vaccine requires taking one capsule every two days for a total of four capsules (eight days in total). The other is a one-time injection of vaccine.
• Each vaccine is equally effective against typhoid fever. However, the capsule vaccine can protect for five years, while the injectable vaccine is only effective for two years.
• It’s also important to note that the capsule vaccine needs to be taken a full week before possible typhoid infection, while the injectable vaccine takes two weeks.

Know the limitations of each vaccine. For injectable vaccines, young children younger than two years of age, patients during a vaccination schedule, and people who are allergic to vaccine components (check with your doctor to determine if you are allergic) should not receive injectable vaccines.

• For oral capsule vaccines, there are even more restrictions. This includes children younger than six years old, people who are immunocompromised or currently ill, people with AIDS/HIV, cancer patients and patients undergoing chemotherapy, people who have taken antibiotics three days before oral administration, steroid users, and people who are allergic to ingredients in vaccines. No one (consult your doctor to determine if you are allergic) should take the capsule vaccine by mouth.

Don’t rely solely on vaccines. The vaccine is only 50%-80% effective in preventing typhoid infection. So use various preventive measures as much as possible, such as paying attention to dietary hygiene.

• Paying attention to dietary hygiene can also help you avoid other illnesses that may be caused by food, including hepatitis A, traveller’s diarrhea, cholera and dysentery.

Tips

• Check as soon as possible to see if the area where you live or will travel puts you at risk for typhoid fever. Don’t wait until the last minute to get vaccinated. The vaccine takes 1-2 weeks (depending on whether it is taken orally or injected) to take effect.
• Typhoid fever can be prevented. Of course, if you do get typhoid, the illness can be treated with antibiotics.