Following ingestion, the bacteria spread from the intestine to the intestinal lymph nodes, liver, and spleen via the blood where they multiply. Salmonella may directly infect the gallbladder through the hepatic duct or spread to other areas of the body through the bloodstream.
Early symptoms are very general and include fever , malaise and abdominal pain .
Weakness , profound fatigue , delirium, obtundation and an acutely ill appearance develop. Typically, children have milder disease and fewer complications than adults. A few people can become carriers of typhoid and continue to shed the bacteria in their feces for years. Although typhoid is common in developing countries, less than 600 cases are reported in the U.S. each year. Vaccines are recommended for travel outside of the U.S., Canada, northern Europe, Australia, and New Zealand, and during epidemic outbreaks.