Typhoid is a bacterial infection caught from contaminated food or water. It causes a fever that climbs higher day by day, along with stomach discomfort and severe tiredness.
Go to hospital immediately if you notice
- Severe stomach pain, especially if sudden and getting worse
- A hard, rigid abdomen
- Vomiting blood, or black tarry stools
- Confusion or unusual drowsiness
- These can mean bleeding or a hole in the intestine, which is a surgical emergency
Overview
Typhoid is caused by a bacterium called Salmonella Typhi. It spreads when food or water contaminated with infected faeces is swallowed — which is why it is closely linked to sanitation and water quality.
The fever is characteristic: instead of spiking straight away, it climbs a little higher each day over the first week, often reaching 39–40°C, and then stays high.
Untreated typhoid can last for weeks and cause serious complications. Treated with the right antibiotic, most people improve within days.
Antibiotic resistance in typhoid is a growing and serious problem in India, which is why the choice of antibiotic should come from a doctor and the course must be completed.
Symptoms of Typhoid Fever
- Fever that rises step by step over several days and then stays high
- Persistent headache
- Marked weakness and tiredness
- Stomach pain and bloating
- Constipation in adults; diarrhoea is more common in children
- Loss of appetite
- Dry cough in some people
- A slower pulse than you would expect for the level of fever
What causes it
- Infection with the bacterium Salmonella Typhi
- Swallowing food or water contaminated with infected faeces
- Common sources include unsafe drinking water, ice, uncooked food washed in contaminated water, and food handled by someone carrying the bacteria
Who is at higher risk
- Drinking water that has not been boiled, filtered or properly treated
- Eating cut fruit, salads or cold food from places with uncertain hygiene
- Poor sanitation in the area you live or travel to
- Not being vaccinated against typhoid
- Close contact with someone who has typhoid or carries the bacteria
Tests and diagnosis
These are the tests doctors commonly use. Which ones you need depends on your symptoms.
- Blood culture — the most reliable test, and the one that confirms typhoid. It also shows which antibiotics will work.
- The blood sample is best taken in the first week of illness and before antibiotics are started.
- Complete blood count, which may show a low white cell count
- The Widal test is widely used in India but is unreliable on its own — see the question below
Treatment
- Antibiotics prescribed by a doctor. Which antibiotic depends on local resistance patterns and, ideally, on your culture result.
- Complete the whole course. Stopping early is a major cause of relapse and of resistant infections.
- Fluids and rest. Paracetamol is normally used for the fever.
- Soft, easily digested food while the intestine recovers.
- Severe cases, and anyone with signs of complications, need hospital treatment.
Prevention
- Drink only water that has been boiled, filtered or properly treated — including the water used for ice
- Eat food that is freshly cooked and served hot
- Be cautious with cut fruit, salads and cold food from outside
- Wash hands with soap before eating and after using the toilet
- Typhoid vaccination, which is available and worth discussing with your doctor
- Anyone who has had typhoid should not handle food for others until cleared, as some people carry the bacteria afterwards
When should you see a doctor?
See a doctor for any fever lasting more than three days, especially if it is climbing steadily and comes with stomach discomfort and severe tiredness. Go to hospital immediately for severe stomach pain, a rigid abdomen, black stools or confusion.
Frequently Asked Questions
Is the Widal test reliable for typhoid?
Not on its own. The Widal test can be positive in people who had typhoid in the past, who were vaccinated, or who have other infections — and it can be negative early in genuine typhoid. Many people are treated for typhoid on a Widal result alone when they do not have it. A blood culture is the test that actually confirms the diagnosis.
How long does typhoid fever last?
Untreated it can continue for three to four weeks. With the right antibiotic, the fever usually starts settling within three to five days, though tiredness can linger for some weeks afterwards.
Can typhoid come back?
Yes. Relapse happens in a minority of people, most often when the antibiotic course was stopped early. Some people also continue carrying the bacteria without symptoms and can pass it to others through food.
Is there a vaccine for typhoid?
Yes, typhoid vaccines are available in India. They do not give complete protection, so safe water and food hygiene still matter, but vaccination meaningfully reduces the risk. Ask your doctor whether it is appropriate for you.
Can typhoid cause death?
Untreated typhoid can be fatal, and before antibiotics existed a significant proportion of people died of it. With prompt diagnosis and the right antibiotic, death is now uncommon. The danger comes from delay and from complications — the most serious is a hole forming in the intestine, usually in the third week, which causes sudden severe stomach pain and needs emergency surgery. This is why a fever that is not settling should be tested rather than treated by guesswork, and why the full antibiotic course must be finished.
Questions to ask your doctor about Typhoid Fever
Pick the three that matter most to you and write them down before your appointment. Consultations are short, and almost everyone forgets at least one.
- Was this confirmed by blood culture, or another test?
- Which antibiotic, and for how long?
- What if I do not improve in three to five days?
- When can I go back to work or school?
- Could I still be carrying it, and should I avoid handling food?
- Should my family be vaccinated?