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Typhoid Fever


Typhoid fever is a disease caused by Salmonella typhi bacteria. It causes fever, headache, loss of appetite and stomach pain and can lead to serious complications like kidney failure or a perforation of the bowel if untreated.

Typhoid fever is reportable to the Iowa Department of Public Health by Iowa Administrative Code 641 IAC 1.


Symptoms can appear anywhere between 3 to 60 days after being infected with S. typhi. At first, symptoms may begin with mild illness and a low fever, but some people do get severe illness right away. Symptoms of typhoid fever include:

  • Fever
  • Headache
  • Malaise
  • Loss of appetite
  • Slowed heart beat
  • Enlarged spleen
  • Constipation
  • Cough
  • Rose colored spots on the trunk

If not treated rapidly, these complications can develop:

  • Bowel perforation
  • Kidney failure


Typhoid fever is caused by eating or drinking food or water contaminated with S. typhi. Some ways to catch typhoid fever include eating shellfish from sewage contaminated beds, vegetables fertilized by human feces, and contaminated raw fruit or milk products. Flies may contaminate foods also.

You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding Salmonella Typhi or if sewage contaminated with Salmonella Typhi bacteria gets into the water you use for drinking or washing food. 

Risk Factors

Typhoid fever is common in most parts of the world except in industrialized regions such as the United States, Canada, western Europe, Australia, and Japan. Therefore, if you are traveling to the developing world, you should consider taking precautions. Other areas of risk include East and Southeast Asia, Africa, the Caribbean, and Central and South America. 


Proper sanitation of public and private facilities is important to prevent typhoid fever. Routine sanitation includes:

  • Proper hand washing, including good hand washing facilities in public places, especially in food service, child care, or health care settings.
  • Proper disposal and treatment of human sewage. Restrooms should be fly-proof and properly designed and situated.
  • Public and private water supplies should be protected, purified, and chlorinated (as needed). Backflow prevention devices should be installed between potable (for drinking) water and non-potable water systems.
  • Cleanliness in food preparation and handling. Proper temperature of raw and cooked foods is critical, as well as avoiding contact between raw meats and items already prepared to eat.
  • All milk and milk products should be pasteurized.
  • Shellfish should be obtained from approved sources.
  • Keep food that will be eaten raw, such as fruit and vegetables, from becoming contaminated by products from animals. Wash all foods eaten raw before eating.
  • Receiving typhoid vaccination when traveling to high-risk areas. Visit for current information on high-risk areas.


Certain antibiotics are used to treat typhoid fever. Sometimes steroid medications are used for those who are seriously ill.


There was one case of typhoid fever in Iowa in 2021. 

For more detailed information and statistics on all notifiable diseases, please see our current annual report located in the reports section of the CADE homepage.

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