Typhoid Fever

58 cases in 2024 — near the 5-year baseline of ~175. All cases in NYS are travel-associated; no local mosquito transmission.

What is it?

Typhoid fever is caused by Salmonella Typhi and spreads through contaminated food and water in developing countries. NYS had 58 cases in 2024, nearly all travel-associated. S. Typhi only infects humans and is spread by people — poor sanitation and contaminated water supplies sustain transmission in endemic areas.

How it spreads

Spreads through eating food or drinking water contaminated by the feces or urine of an infected person. Food handlers who are chronic carriers can contaminate food. Not spread through casual contact.

Symptoms

Gradual onset of sustained (not intermittent) high fever over 1–3 weeks, along with headache, weakness, abdominal pain, and constipation or diarrhea. A rose-colored rash ("rose spots") may appear on the trunk. Complications include intestinal perforation and hemorrhage.

Who is at risk?

Travelers to South Asia (especially India, Pakistan, Bangladesh) and other developing countries with poor sanitation and water treatment.

What you can do

Vaccine information

Two typhoid vaccines are available: an injectable polysaccharide vaccine (Typhim Vi) that requires a booster every 2 years, and an oral live-attenuated vaccine (Vivotif, 4 capsules) that provides protection for 5 years. Both are about 50–80% effective.

Based on NYSDOH annual communicable disease report. Threat level reflects 2024 case counts compared to the 5-year baseline.