What foods and beverages should children with typhoid fever avoid?

Dietary Restrictions for Children with Typhoid Fever

Children with typhoid fever should avoid unpasteurized dairy products, raw or undercooked meats and eggs, raw produce, unpasteurized juices, contaminated water, and foods prepared outside the home by potentially infected food handlers.

High-Risk Foods and Beverages to Avoid

Dairy Products

• Unpasteurized milk and dairy products pose significant risk for transmission of enteric pathogens and should be strictly avoided 1
• Soft cheeses made from unpasteurized milk carry increased risk 1

Meat, Poultry, and Eggs

• Raw or undercooked meats of any type should be avoided 1
• Undercooked poultry must be avoided; if consumed, poultry should reach an internal temperature of 180°F 2
• Raw or undercooked eggs and foods containing them should not be consumed 2
• Unheated deli meats carry risk and should be avoided 1

Produce and Juices

• Raw vegetables that haven't been thoroughly washed should be avoided 2
• Raw leafy vegetables like lettuce and spinach pose contamination risk 2
• Raw seed sprouts are high-risk items 2
• Unpasteurized fruit juices can transmit enteric pathogens 2
• 100% fruit juice should be limited even when pasteurized 1

Water and Beverages

• Contaminated water from lakes, rivers, or during boil-water advisories must be avoided 2
• Ice made from contaminated tap water should not be consumed 2
• Caffeine should be avoided in children 1

Foods Prepared Outside the Home

• Foods purchased from street vendors or prepared outside the home carry higher risk, particularly flavored ices and foods shared with classmates 3
• School lunches and foods shared between children have been identified as risk factors for typhoid transmission 3

Critical Food Safety Principles During Illness

Cross-Contamination Prevention

• Uncooked meats must never contact other foods; all surfaces, cutting boards, utensils, and hands require thorough washing after contact with raw foods 2
• Proper food handling practices must be maintained to avoid cross-contamination during grocery shopping, food preparation, and storage 1

Proper Cooking Temperatures

• Red meats should reach internal temperature of 165°F 2
• Poultry should reach 180°F 2

Additional Dietary Considerations

Foods to Limit

• Added sugars should be limited 1
• High sodium foods should be limited 1
• Saturated fats should be limited 1

Hydration Management

• Adequate hydration with oral rehydration solution or IV fluids is essential, as dehydration increases risk of life-threatening complications, especially in infants 4, 5
• Continue breastfeeding throughout illness if the infant is breastfed 4, 5

Hand Hygiene and Transmission Prevention

Meticulous hand hygiene is critical and should be performed after using the toilet, changing diapers, before and after preparing food, before eating, and after handling garbage or soiled laundry 1

Hand-washing with soap is particularly important as typhoid is transmitted through the fecal-oral route, and human feces must always be considered potentially hazardous 1

Common Pitfalls to Avoid

The infectious dose for enteric pathogens can be extremely low (less than 100 organisms for some E. coli strains), making even minor lapses in food safety potentially dangerous 2. Parents often underestimate the risk of foods prepared outside the home, which epidemiological studies have identified as a major transmission vehicle for pediatric typhoid fever 3.