Typhoid Fever: Symptoms, Causes, Stages & How Long Does it Last?

What is Typhoid Fever?

Typhoid fever is a bacterial infection caused by Salmonella Typhi. It mainly spreads through contaminated food or water and can lead to serious health issues if not treated properly. The illness often begins gradually, with fever, weakness, stomach pain, and loss of appetite. If left untreated, it can last for weeks or even months. 

However, with timely medical attention and proper care, recovery is achievable. Typhoid fever treatment is available and effective in most cases, allowing you or your loved one to return to normal health with time and support.

Who Does Typhoid Fever Affect?

Typhoid fever can affect anyone, but some groups are more vulnerable than others.

How Common is Typhoid Fever?

• It’s more common in certain regions: Typhoid fever is a major health issue in areas with limited access to clean water and sanitation, especially parts of Asia, Africa, and Latin America.
• Children and young adults are at higher risk: Their immune systems are still developing, and they may unknowingly consume contaminated food or drinks.
• Travellers may be exposed abroad: People visiting regions where the infection is endemic are at a higher risk, especially if food and water safety precautions aren't followed.
• People in crowded or unsanitary living conditions: Refugees, residents in slums, and those without access to clean facilities are more prone to infection due to poor hygiene practices.
• Healthcare and laboratory workers: Those working with bodily fluids from infected individuals may be at risk if proper protective measures aren't taken.

What’s a Long-term Carrier of Typhoid Fever?

Some people, even after recovery, continue to carry the bacteria without showing any symptoms. These individuals are known as chronic carriers.

• They can unknowingly spread the disease: Despite having no symptoms, they may still pass the bacteria through their faeces or urine.
• Chronic carriers are identified through testing: Stool or urine tests over time can reveal persistent infection.
• They may require extended antibiotic treatment: In some cases, typhoid fever treatment for carriers may differ from acute cases, involving longer courses or different antibiotics.
• Gallbladder removal may be recommended: For persistent carriers, especially those with gallstones, surgery might be advised to eliminate the source of the bacteria.

Typhoid Fever Symptoms

You may experience typhoid fever symptoms within 6 to 30 days after exposure. Symptoms tend to appear gradually and worsen over time without treatment.

• Persistent high fever: Often rising to 39–40°C (102–104°F), this is a hallmark sign and may not subside on its own.
• Weakness and fatigue: You might feel unusually tired or drained, even after resting, making daily tasks challenging.
• Stomach pain and discomfort: Abdominal pain, bloating or cramping is quite common and may be accompanied by nausea.
• Loss of appetite and weight loss: This may occur as a result of nausea and general discomfort.
• Constipation or diarrhoea: Some people experience alternating bowel habits, especially in children (diarrhoea) and adults (constipation).
• Headache and body aches: General malaise, including muscle pain and headache, adds to the discomfort.
• Dry cough: A mild, persistent cough may develop in the early stages.
• Rose-coloured spots: Small pink spots may appear on the chest or abdomen, although not everyone gets them.

Typhoid Fever Causes

Being familiar with the typhoid fever causes helps prevent it more effectively.

• Ingesting contaminated food or water: The most common cause is eating or drinking something tainted with Salmonella Typhi bacteria.
• Poor hygiene and sanitation: Lack of clean water, improper sewage disposal, and unhygienic food handling are major contributors.
• Direct contact with infected individuals: You can catch the bacteria through close contact with someone who is infected or is a chronic carrier.
• Travelling to endemic areas: Travellers to countries where typhoid is common are at a higher risk if precautions aren’t taken.
• Household transmission: If a family member is infected, shared bathrooms or food surfaces can become a source of spread.

What are the Stages of Typhoid Fever?

Typhoid progresses in phases if untreated. These 4 stages of typhoid fever help explain how the condition worsens over time.

• Week 1 – Initial signs: You may feel fatigue, rising fever, headaches, and a dry cough. The illness may mimic flu at first.
• Week 2 – Worsening symptoms: Fever continues, and digestive issues like abdominal pain, diarrhoea or constipation become more intense. Rose spots may appear.
• Week 3 – Severe complications: If left untreated, symptoms can become severe. Intestinal bleeding or perforation may occur, needing urgent medical attention.
• Week 4 – Recovery or risk: With proper typhoid fever treatment, symptoms begin to improve. Without treatment, complications or even death may occur. Some may relapse in this stage.

How Does Typhoid Fever Spread?

Typhoid fever spreads through the faecal-oral route. This means the bacteria from the stool or urine of an infected person can contaminate food, water, or surfaces. You might catch it by eating unwashed fruits, drinking untreated water, or touching your mouth with unclean hands. 

In communities lacking proper sanitation, the infection can spread rapidly. This makes handwashing, safe food handling, and access to clean water crucial.

How is Typhoid Fever Diagnosed?

Doctors rely on your symptoms, travel history, and lab tests to confirm typhoid.

• Symptom review: Persistent fever, stomach pain, and fatigue are key indicators.
• Travel history analysis: Let your doctor know if you've recently been to regions where typhoid is common.
• Physical examination: Your doctor may check for rose spots, enlarged spleen or liver, and signs of dehydration.

What Tests can be Done to Diagnose Typhoid Fever?

Several tests help confirm if you have typhoid fever.

• Blood culture: A small blood sample is taken to grow and detect the bacteria. This is often the most accurate test during the first week.
• Stool test: Used to detect the bacteria later in the illness, especially if symptoms persist.
• Urine test: Sometimes used alongside stool tests to improve accuracy.
• Bone marrow test: Considered the gold standard, it can detect bacteria even after antibiotics have been started, though it’s rarely needed.
• Widal and TyphiDot tests: These rapid tests help detect antibodies but are less reliable and are often used in areas without access to cultures.

Treatment for Typhoid Fever

Don’t worry—typhoid fever treatment is highly effective when started early.

• Antibiotics are the primary treatment: These help kill the bacteria and reduce symptoms within a few days.
• Hydration support is vital: You may need oral rehydration salts or intravenous fluids if you're dehydrated.
• Bed rest helps with recovery: Fatigue is common, so allow your body time to heal fully.
• Regular fever monitoring is important: Keep track of your temperature and report spikes to your doctor.
• Nutritional support: Eating small, soft meals can help reduce digestive strain.
• Follow your doctor’s course: Complete the full antibiotic course, even if symptoms improve quickly.
• Hospitalisation may be needed in severe cases: Especially if there are signs of intestinal perforation or very high fever.
• Watch for complications or relapse: After treatment, some people may experience a second bout. Be sure to attend follow-up appointments.

What are Safe Food Practices to Prevent Typhoid Fever?

Prevention begins in the kitchen and while travelling.

• Drink bottled or boiled water: Avoid tap water in unfamiliar areas. Use sealed bottled water or purify it.
• Eat well-cooked foods only: Make sure meat and vegetables are cooked through and served hot.
• Avoid raw produce and street food: These may be washed with contaminated water or handled unhygienically.
• Wash hands regularly: Always wash before eating or preparing food, especially after using the bathroom.
• Clean cooking surfaces and utensils: Avoid cross-contamination between raw and cooked foods.
• Peel fruits and avoid salads outside home: Unless prepared in hygienic settings, raw food can be risky.

What Medications are Used to Treat Typhoid Fever?

Your doctor will prescribe antibiotics based on local resistance patterns.

• Ciprofloxacin (for non-resistant strains): A commonly used antibiotic for adults, though resistance is increasing.
• Azithromycin: Often used when resistance to older antibiotics is suspected.
• Ceftriaxone (injections): Used in severe or resistant cases, often administered in hospitals.
• Paracetamol for fever relief: Helps manage your temperature while antibiotics do their work.
• Probiotics may be advised: To restore gut bacteria balance after antibiotics.
• Complete the entire course: Stopping early can lead to relapse or bacterial resistance, delaying recovery.

Prevention

Being proactive can protect you and your family from typhoid.

• Get vaccinated before travel: If you're visiting a high-risk area, typhoid vaccination offers protection.
• Maintain good hygiene habits: Frequent handwashing is one of the simplest and most effective prevention methods.
• Drink and eat safely: Always choose clean, bottled water and hygienically prepared food.
• Avoid sharing food and utensils with others: This reduces the risk of transmission from carriers.
• Report symptoms early: Quick treatment reduces complications and the risk of spreading it to others.
• Educate others around you: Awareness can go a long way in preventing outbreaks.

What Can I Expect if I Have Typhoid Fever?

If you've been diagnosed with typhoid fever, it’s understandable to feel concerned. But with proper care, the outlook is positive. Most people recover fully with typhoid fever treatment, although recovery can take several weeks. 

You may feel weak or tired for a while, and some may experience a relapse. Close follow-up and good hygiene help prevent spread and re-infection.

Typhoid Relapse

Even after recovery, the illness might return in a few weeks.

• Relapses are usually milder: The second bout is often less intense than the first.
• You’ll need another antibiotic course: Follow-up treatment is usually effective.
• Watch for familiar symptoms: Fever, fatigue, and stomach issues can signal relapse.
• Stay in touch with your doctor: They’ll monitor your recovery and provide guidance.

Complications of Typhoid

Although rare with treatment, complications can arise.

• Intestinal perforation: A hole in the bowel wall can cause severe abdominal pain and requires emergency surgery.
• Internal bleeding: Can occur in the digestive tract, leading to blood in stools or vomit.
• Sepsis: The infection may spread into the bloodstream and affect other organs.
• Psychological fatigue: Ongoing tiredness or low mood is common during recovery.
• Urinary or gallbladder issues in carriers: These may require further intervention or monitoring.

Conclusion

Typhoid fever can feel overwhelming, but with early diagnosis and proper care, full recovery is absolutely possible. Understanding the symptoms, causes, and stages helps you take the right steps. If you notice any persistent signs, it’s best to consult a healthcare provider and get tested promptly.

For reliable and accurate testing, Metropolis Healthcare is a trusted choice. With NABL-accredited labs, expert pathologists, and convenient home collection services, they ensure timely diagnosis and peace of mind for you and your family.

FAQs

Q1. How can I reduce my risk of typhoid fever?

Drink clean water, eat properly cooked food, wash hands regularly, and get vaccinated before travelling to risky areas.

Q2. What are the signs of recovery from typhoid fever?

Fever subsides, appetite returns, energy improves, bowel movements normalise, and you begin to feel stronger each day.

Q3. How long does typhoid fever last?

Without treatment, it may last weeks; with antibiotics, symptoms usually improve within 3 to 5 days.

Q4. Who was Typhoid Mary?

Mary Mallon was an asymptomatic carrier of typhoid who unknowingly infected dozens while working as a cook.

Q5. How did countries get rid of typhoid fever?

Improved sanitation, clean drinking water, widespread vaccination, and public health education significantly reduced typhoid in developed countries.

Q6. Can you still be contagious with typhoid fever after you get better?

Yes, some people become chronic carriers and continue to shed bacteria through stool without showing any symptoms.

Q7. Does typhoid spread by kissing?

It’s unlikely, but possible if there’s contact with saliva or poor hygiene after bathroom use or contamination.