Typhoid Fever: Symptoms, Tests, Treatment and Prevention

When a fever drags on for more than a few days during the Bangladeshi summer or monsoon, typhoid is one of the first illnesses doctors think of. Spread through contaminated food and water, typhoid remains common across the country, from crowded cities to villages. The illness is very treatable when handled properly, but self-medication and half-finished antibiotic courses are turning it into a harder-to-treat problem. Knowing the symptoms and getting tested early makes all the difference.

What is typhoid and how does it spread?

Typhoid is a bacterial infection caused by Salmonella Typhi. It spreads when food or water contaminated with the bacteria — usually from an infected person's stool — is swallowed. In Bangladesh, unsafe drinking water, street food, cut fruit washed in dirty water and poor hand hygiene are the usual culprits, which is why outbreaks rise during the monsoon and in areas with weak sanitation. It can affect anyone but is especially common in children and young adults.

What are the symptoms of typhoid?

The classic feature is a "step-ladder" fever that climbs a little higher each day over a week, often reaching 103-104°F. Symptoms usually begin one to two weeks after the bacteria are swallowed. Alongside the fever, several other symptoms are common.

• Persistent high fever, often worse in the evening.
• Headache, body aches and marked weakness.
• Loss of appetite and abdominal pain or discomfort.
• Constipation or diarrhoea, and sometimes a coated tongue.
• A slow pulse and, in some cases, faint rose-coloured spots on the skin.

Which test confirms typhoid — blood culture or Widal?

Blood culture is the most reliable test, especially in the first week, because it actually grows the bacteria and can guide the right antibiotic. The Widal test is cheap and widely used but is unreliable on its own — it can show false positives from past infection or other illnesses. Doctors interpret it carefully, ideally alongside a blood culture, rather than treating on a single Widal result.

How is typhoid treated?

Typhoid is treated with antibiotics prescribed by a doctor, chosen according to local resistance patterns and ideally guided by the blood culture. The single most important rule is to finish the full course exactly as prescribed, even after the fever settles. Stopping early lets the strongest bacteria survive and fuels drug resistance — a growing danger explained in our guide on why you should never self-prescribe antibiotics. Never buy antibiotics over the counter and never use leftover pills.

• Take medicines at the right times and complete the whole course.
• Rest well, drink plenty of safe fluids and eat soft, easily digestible food.
• Use paracetamol for fever only as advised by your doctor, not random fever mixtures.

How can you prevent typhoid?

Typhoid is largely preventable with safe water, clean food and good hygiene. A vaccine adds further protection, especially for children and travellers. Protecting the water supply and washing hands properly breaks the chain of infection.

• Drink safe water: boil, filter or use purified water, particularly during the monsoon.
• Eat carefully: choose freshly cooked hot food and avoid uncovered street food and cut fruit.
• Wash hands: with soap before eating and after using the toilet.
• Get vaccinated: ask your doctor about the typhoid vaccine, which is recommended in high-risk areas.

When should you see a doctor?

See a doctor for any fever lasting more than three days, rather than guessing or self-treating. Seek urgent hospital care if there is severe abdominal pain, persistent vomiting, blood in the stool, black stools, confusion, or a fever that will not come down — these can signal dangerous complications such as intestinal bleeding or perforation. To get the right tests and a proper antibiotic plan, book a verified doctor on ChamberBD to consult a physician early in the illness.

This article is for general health education and is not a substitute for professional medical advice.