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.

Risk Factors

Typhoid fever occurs worldwide to millions of people so travel to places where typhoid fever is occurring is the biggest risk. Living, eating and drinking in places where sanitation is poor increases risk. If people who are infected prepare food or drink for others, the risk of infecting others is increased, even if they are not ill.


  • 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 www.cdc.gov/travel/ 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.


Seven cases of typhoid fever was reported in 2015.

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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