Typhoid fever classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Aslam, M.B.B.S[2]


There is no established classification system for typhoid fever. Typhoid fever may be classified informally based on duration of illness, serologic type, severity of illness, and virulence factors.[1]


There is no established classification system for typhoid fever. However, typhoid fever may be classified informally as follows.[1]

Duration of illness

Acute disease [2][3][4]

  • Sudden-onset
  • Severe in nature
  • Lasts < 12 months
  • Mostly symptomatic

Chronic disease [2][3][4]

  • Lasts > 12 months
  • Less severe
  • Asymptomatic
  • Spread infection to others

Severity of illness

Mild disease[5][6]

Moderate to severe disease[7][6]

Virulence factors

High virulence factors[8][9][1]

  • PhoP/phoQ genes
  • CdtB protein
  • Vi antigen-positive strains

Low virulence factors[3][10][11]

  • Absence of above factors
  • Presence of following host factors
  • C282 mutation
  • CFTR mutation


  1. 1.0 1.1 1.2 Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ (2002). "Typhoid fever". N Engl J Med. 347 (22): 1770–82. doi:10.1056/NEJMra020201. PMID 12456854.
  2. 2.0 2.1 Lai CW, Chan RC, Cheng AF, Sung JY, Leung JW (1992). "Common bile duct stones: a cause of chronic salmonellosis". Am J Gastroenterol. 87 (9): 1198–9. PMID 1519582.
  3. 3.0 3.1 3.2 Hofmann E, Chianale J, Rollán A, Pereira J, Ferrecio C, Sotomayor V (1993). "Blood group antigen secretion and gallstone disease in the Salmonella typhi chronic carrier state". J Infect Dis. 167 (4): 993–4. PMID 8450268.
  4. 4.0 4.1 Dham SK, Thompson RA (1982). "Humoral and cell-mediated immune responses in chronic typhoid carriers". Clin Exp Immunol. 50 (1): 34–40. PMC 1536860. PMID 7172510.
  5. Bhutta, Zulfiqar Ahmed. "Impact of age and drug resistance on mortality in typhoid fever." Archives of disease in childhood 75.3 (1996): 214-217.
  6. 6.0 6.1 Hoffman SL, Punjabi NH, Kumala S, Moechtar MA, Pulungsih SP, Rivai AR; et al. (1984). "Reduction of mortality in chloramphenicol-treated severe typhoid fever by high-dose dexamethasone". N Engl J Med. 310 (2): 82–8. doi:10.1056/NEJM198401123100203. PMID 6361558.
  7. Bhutta, Zulfiqar Ahmed. "Impact of age and drug resistance on mortality in typhoid fever." Archives of disease in childhood 75.3 (1996): 214-217.
  8. Hohmann EL, Oletta CA, Killeen KP, Miller SI (1996). "phoP/phoQ-deleted Salmonella typhi (Ty800) is a safe and immunogenic single-dose typhoid fever vaccine in volunteers". J Infect Dis. 173 (6): 1408–14. PMID 8648213.
  9. Spanò S, Ugalde JE, Galán JE (2008). "Delivery of a Salmonella Typhi exotoxin from a host intracellular compartment". Cell Host Microbe. 3 (1): 30–8. doi:10.1016/j.chom.2007.11.001. PMID 18191792.
  10. Darton TC, Blohmke CJ, Giannoulatou E, Waddington CS, Jones C, Sturges P; et al. (2015). "Rapidly Escalating Hepcidin and Associated Serum Iron Starvation Are Features of the Acute Response to Typhoid Infection in Humans". PLoS Negl Trop Dis. 9 (9): e0004029. doi:10.1371/journal.pntd.0004029. PMC 4578949. PMID 26394303.
  11. Weinberg ED (2008). "Survival advantage of the hemochromatosis C282Y mutation". Perspect Biol Med. 51 (1): 98–102. doi:10.1353/pbm.2008.0001. PMID 18192769.

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