Salmonellosis (Typhoid Fever/Paratyphoid Fever)

Reportable by Laboratories and Providers

About this Reportable Disease

Infectious agent: Typhoid fever: Salmonella enterica serotype Typhi (Salmonella Typhi). Prathyroid fever: Salmonella enterica serotypes Paratyphi A. B [tatrate negative], and C [S. Paratyphi]

Description of illness: Symptoms of typhoid fever and paratyphoid fever are different from other types of Salmonella infection and include sustained high fever, weakness, stomach pain, headache, and loss of appetite. Individuals with typhoid fever or paratyphoid fever carry the bacteria in their bloodstream and intestinal tract. Some recover from the illness but become carriers of the bacteria and continue to shed S. Typhi/paratyphi in their stool. In the United States, most cases are acquired while traveling internationally.

Interactive Disease Data

Laboratory Reporting for this Disease

Salmonella species

TEST NAME	Salmonella species
DISEASE/DISORDER	Diarrheal disease
ALTERNATE NAME(S)	Enteric pathogens, stool culture, aerobic bacterial stool culture, Salmonella stool culture
METHODOLOGY	Culture
SPECIAL INSTRUCTIONS	Isolate or specimen submission required Contact CEDEP if foodborne outbreak is suspected
ORDERING INFORMATION	TDH DLS Requisition: PH-4182 Clinical Submission Requisition

Specimen Requirements

Patient Preparation	Medications: Do not use barium or bismuth before collection of specimen
Specimen Collection	Stool - C&S Culture Transport Media (i.e. ParaPak) - Semisolid or liquid transport media (i.e. Cary Blair or Amies) - Commercially available transport system specific for recovery of enteric pathogens from fecal specimens Isolate - Pure cultures
Specimen Labeling	Specimen must be labeled with at least two unique patient identifiers and match accompanying PH-4182 Clinical Submission Requisition.
Specimen Processing	None
Specimen Storage and Preservation	Stool specimens should be stored at 2-30°C and arrive at the laboratory within 4 days of specimen collection. If possible, refrigerate at 2-8°C. Isolates should be stored at ambient conditions and submitted within 2 weeks of isolation.
Specimen Transport	Ship stool specimens at 2-30°C with cold packs. If possible, maintain at 2-8°C. Ship isolates at ambient temperature. All infectious substance shipments must conform to U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR 49 C.F.R. Parts 171-180).
Specimen Acceptability and Rejection	Specimens that do not adhere to all specimen requirements will be rejected.
Testing Location	Nashville

Laboratory Reporting

Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.

Manually report results to TDH by faxing or mailing a completed PH-1600 form to your local health department, or faxing to the state health office at (615) 741-3857
Automatically submit results to TDH via electronic laboratory reporting (ELR), which automates the process of sharing data with TDH using interoperability standards.
- See the ELR Onboarding Handbook for details on the onboarding process, checklist, frequently asked questions, business rules, message format, and vocabulary.
- To initiate the ELR onboarding process with TDH, register in the Trading Partner Registration (TPR) system TPR provides documentation for Promoting Interoperability (PI) attestation and milestone letters to document onboarding progress. Contact MU.Health@tn.gov for assistance.
Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.

Information about this Reportable Disease for Healthcare Providers

Clinical Summary

Typhoid fever and paratyphoid fever (enteric fever) are systemic bacterial infections caused by Salmonella Typhi and Salmonella Paratyphi, respectively, with an insidious onset of fever, headache, malaise, myalgias, and constipation or diarrhea; some patients develop rose spots.
Transmission is fecal–oral, typically via contaminated food or water; people may become chronic carriers and continue shedding bacteria in stool after symptoms resolve, which has implications for case investigation and risk mitigation.
Diagnosis is clinical plus laboratory confirmation (commonly culture-based testing); antimicrobial resistance is an ongoing concern, so susceptibility data should guide therapy when available.
Treatment is with antibiotics, and timely treatment reduces complications and death risk; the choice of regimen depends on travel region/resistance patterns and clinical severity.
In Tennessee, typhoid/paratyphoid fever is a reportable condition; coordinate notification and public health follow-up per TDH guidance.

Clinical Links & Info

Clinical information about this disease | CDC

Review the case definition | CDC

Access the case report form (2018) | TDH

Collecting laboratory samples | CDC

Healthcare Provider Reporting

Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.

Providers must report cases of all diseases and conditions listed through one of these methods:

• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857

• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.

• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.

• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.

Information about this Reportable Disease for the Public

What It Is

Typhoid fever and paratyphoid fever are serious illnesses caused by Salmonella bacteria (Typhi or Paratyphi) that affect the whole body (not just the intestines).

Signs and Symptoms

Symptoms can include sustained high fever, weakness, stomach pain, headache, and loss of appetite; bowel habits may change (constipation or diarrhea).

How It Spreads

These infections spread through the fecal–oral route, often from consuming contaminated food or water. Some people can continue to shed the bacteria in stool after they feel better.

Diagnosis and Treatment

Healthcare providers diagnose typhoid/paratyphoid fever with lab testing and treat it with antibiotics. Getting treated promptly helps reduce the risk of serious complications.

Prevention

Prevention includes careful hand hygiene and safe food and water choices, especially during travel. Vaccines are available for typhoid fever (but available vaccines do not protect against paratyphoid fever).

This Page Last Updated: March 25, 2026 at 8:53 PM