Typhoid fever is a serious infection caused by the bacterium Salmonella Typhi. It is typically spread through contaminated food or water. Once ingested, the bacteria multiply and spread into the bloodstream.
Typhoid fever is most common in poorer countries with poor hygiene and sanitation. It is highly contagious and is mainly spread through contaminated food or water. Rapid urbanisation and climate change have the potential to make the disease more widespread.
Salmonella Typhi lives only in humans. People with typhoid fever carry the bacteria in their bloodstream and intestinal tract.
Symptoms of typhoid fever include:
Severe cases of typhoid may lead to serious complications or even death.
Typhoid fever is usually spread through contaminated food or water. The bacteria is shed in the faeces of people who have symptoms and people who are no longer sick, but still carry the bacteria.
Typhoid bacteria can be ingested by:
Typhoid fever can be treated with antibiotics. However, antimicrobial resistance is a growing threat and can lead to more complicated and expensive treatment options. A drug resistant form of the disease that emerged in Pakistan is beginning to spread around the world, with 702 cases in the UK in 2024 – an eight per cent increase compared to the year before.
Typhoid fever is common in places with poor sanitation and a lack of safe drinking water. Therefore, access to safe water, adequate sanitation, hygiene among food handlers and typhoid vaccination are all effective in preventing typhoid fever.
Two new typhoid conjugate vaccines were approved by the World Health Organization in 2017 and are being introduced in countries where the disease is endemic.
The vaccine is not offered routinely in the UK as the risk of acquiring the disease here is low, however it should be offered to travellers to countries where the disease is more common.
Other preventive measures include:
Typhoid fever has been around for thousands of years. Infectious diarrhoea and dysentery were described clearly by Hippocrates.
Typhoid has ravaged societies with poor food and water hygiene. In the 19th and early 20th centuries, there was high transmission of typhoid in North America and Europe, affecting both the rich and poor. Prince Albert – husband of Queen Victoria – died of typhoid fever.
One of the most famous victims of the disease was Mary Mallon, an Irish cook, who was an asymptomatic carrier of the disease and unknowingly infected hundreds of people when she emigrated to America. The term ‘typhoid Mary’ is now synonymous with the spread of the disease.
The bacteria that causes typhoid fever was first discovered in the 1880s, and the first vaccine was developed in 1896 by British and German scientists and became more widely used from 1911. The development of a vaccine and antibiotics, as well as the expansion of water and sanitation systems, reduced the spread of the disease.
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