Typhoid Fever


Cause: Bacterium Salmonella Typhi.

Illness and treatment: Symptoms include fever, headache, rash, constipation or diarrhea, and lymph node swelling. Severity ranges from mild febrile illness to severe disease with multiple complications. Treatment is with antibiotics.

Sources: Humans are the reservoir and transmit through fecal contamination of food, water or milk, or directly person-to-person.

Additional risks: There can be a prolonged intestinal carrier state, sometimes due to gallbladder infection; re-culture patients after antibiotic treatment to confirm clearance of the infection.

Prevention: If traveling to risk areas, consult with a travel clinic or the CDC Travelers' Health website for recommendations about vaccination and other measures.

Recent Washington trends: Cases occur mainly after international travel, most commonly to Asia. Case counts are variable, ranging from 5 to 22 reports each year.

Purpose of Reporting and Surveillance

  • To determine if there is a source of infection of public health concern (e.g., a food handler or commercially distributed food product) and to stop transmission from such a source
  • To assess the risk of the case transmitting infection to others, and to prevent such transmission
  • To identify other undiagnosed cases

Legal Reporting Requirements

  • Health care providers and Health care facilities: notifiable to local health jurisdiction within 24 hours
  • Laboratories: Salmonella species including S. Typhi notifiable to local health jurisdiction within 24 hours; submission required – isolate or if no isolate specimen associated with a positive result, within 2 business days
  • Local health jurisdiction: notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE) within 7 days of case investigation completion or summary information required within 21 days