Typhoid fever

Symptoms of typhoid fever

The symptoms of typhoid fever usually develop one to two weeks after a person becomes infected with the Salmonella typhi bacteria.

If typhoid fever is not treated, the symptoms will develop over four weeks, with new symptoms appearing each week. With treatment, the symptoms should quickly improve within three to five days.

The first week

Symptoms of typhoid fever during the first week of infection include:

  • a high temperature (fever) that can reach 39–40C (103–104F), which usually increases throughout the day before falling the following morning
  • abdominal pain
  • constipation or diarrhoea – adults tend to get constipation and children tend to get diarrhoea
  • vomiting – this usually affects children rather than adults
  • a dry cough
  • a dull headache that can be felt at the front of the head
  • severe mental confusion, such as not knowing where you are or what is going on around you
  • a skin rash made up of pink spots that are 1–4cm wide – there are usually fewer than five spots
  • a feeling of being increasingly very unwell

The second week

In the unlikely event that you do not get treatment, the symptoms above will become more severe in the second week.

You may also have:

  • a swollen abdomen
  • a slow heartbeat

The third week

During the third week, the symptoms of typhoid fever include:

  • loss of appetite
  • weight loss
  • physical exhaustion
  • bouts of foul-smelling, yellow–green, watery diarrhoea
  • severe swelling of the abdomen
  • rapid breathing
  • a deterioration of your mental state, such as severe confusion, apathy and, in some cases, psychosis (where a person is unable to tell the difference between reality and their imagination)

During the third week, 1 in 10 people will also develop serious complications, such as internal bleeding.

Read more about the complications of typhoid fever.

When to seek medical advice

It is recommended that you see your GP if you have a high temperature, particularly if you have recently returned from travelling abroad.

It is unlikely that a high temperature will be caused by typhoid fever, but will usually be caused by some sort of infection.

If you become ill while travelling abroad, you can get help by:

  • contacting a representative of the travel company you booked with
  • contacting your travel insurer
  • contacting the British consulate in the area you are visiting or, if you are feeling very ill, the local emergency services

The Foreign & Commonwealth Office (FCO) provides travel advice by country, and their website has the contact details of all the British consulates and embassies in foreign countries.

Before you travel, it is a good idea to make a list of relevant contact details and telephone numbers in case of an emergency.


Bacteria are tiny, single-celled organisms that live in the body. Some can cause illness and disease and others are good for you.

Constipation is when you pass stools less often than usual, or when you have difficulty going to the toilet because your stools are hard and small. 

Diarrhoea is the passing of frequent watery stools when you go to the toilet.

A fever is when you have a high body temperature (over 38C or 100.4F).

Last updated: 31 January 2012

Continue to next section: Causes of typhoid fever