Could Typhoid Fever, Small Pox, and Cholera Pop up Again?

Multiple 1800s era diseases once thought eradicated from modern society are showing up again in cities not only around the world, but in the United States, as well. Cases of typhoid fever, cholera, and monkeypox, which is similar to smallpox, have emerged.

Filthy living conditions, urine, feces, and decaying food, unclean drinking water, and infected rodents are the root causes of all these potentially deadly diseases. The burgeoning homeless populations in major cities around the United States is a prime breeding ground for a second coming of these “plagues”.

Now, infected people can call 911 and rely on prescription antibiotics for help. During a long-term disaster, that will not be possible. Epidemic and pandemics of this sort have often been a cause for concern by the prepping community – and with good reason.

When the trash company can no longer make weekly stops at your house, water does not flow from the faucet, and the refrigeration of food is not possible, the conditions are ripe for the re-emergence of not only typhoid, cholera, smallpox or monkeypox, but the measles, polio, and a myriad of other nasty and potentially fatal illnesses.

Typhoid Fever Outbreak

A Los Angeles police officer was diagnosed with typhoid fever – and he is not the first law enforcement employee in the California city to contract the deadly disease in the past year.

Los Angeles, like San Francisco, New York, and a growing list of American cities under liberal control, could be in the midst of another outbreak which may have spurred the typhoid fever outbreak.

The hundreds to thousands of people living on the 50-block area that comprises Skid Row have taken over not just the sidewalks, but the walkway of the police station that serves the area.

LAPD employees are forced to walk through feces, urine, used needles, decaying food – and rats, just to get to work every day. The germs that are collected on their shoes and clothing are then carried with them into the department, stores, and ultimately home where their family lives.

The Skid Row area police department, the Central Division station, suffered a scathing review during a health inspection last month. Multiple violations were found inside the facility, including an ineffective extermination regarding the rats, fleas, cockroaches, and mosquitoes that were found inside, according to a Daily Mail report.

City workers wear masks and gloves to clean the sidewalks – temporarily relocating the homeless people and their possibly contaminated belongings, in the process. The tents and tarps the folks live in can no longer be thrown into the garbage truck by the sanitation workers.

Legal action taken to ensure city workers could not “steal” the tents and other personal items belonging to the homeless during the cleaning of the public sidewalks.

The items are now collected, tagged, and stored by the city to ensure their owners can pick them up later if they choose to do so – further spreading the possible germs to even more employees, their vehicles, municipal storage spaces, and the homes of workers.

The total breakdown of this city, now, before the SHTF when laws should be in place to protect local heroes and the public, is deplorable. To date, five LAPD staffers are showing symptoms of typhoid fever.

Until now, at least, typhoid disease was considered all but eradicated in the United States, with only about 300 cases stemming from food handling, occuring on an annual basis.

Ponder for just a moment, fellow preppers, how the city and even small town streets will resemble the sidewalks of Skid Row during a long-term disaster.

Those non-preppers who live in urban areas will be fleeing their homes during a doomsday event, running as fast as they can “out in the country” where the majority of preppers live – bringing any disease they are carrying with them.

man with typhoid fever

What Is Typhoid Fever?

Typhoid fever is a life-threatening disease caused by Salmonella serotype Typhi and Salmonella serotype Paratyphi. Until the recent outbreak in Los Angeles, it was believed most cases of typhoid fever in the United States were initially contracted and then spread, but people who had visited foreign countries where such 1800s era illnesses are still commonplace.

While typhoid fever can be treated effectively, in most cases, by prescription antibiotics, some drug-resistant strains have now materialied in Pakistan and parts of Southeast Asia.

Typhoid Fever Symptoms

  • Sustained fever that can hit as high as 104 degrees.
  • Stomach Pain
  • Persistent Dry Cough
  • Weakness
  • Headache
  • Constipation or Diarrhea
  • Extremely Swollen Abdomen
  • Loss of Appetite
  • Lethargy

In some cases, patients with either typhoid fever or paratyphoid fever can develop a rash consistently of rose-colored non-raised spots. It takes a blood or stool test, or both, to diagnose typhoid fever.

To help shed some informed light on how poor sanitation spreads disease and the typhoid outbreak, I reached out to some of my prepping mentors.

Dr. Joe Alton and his wife, Amy Alton (better known as Dr. Bones and Nurse Amy) are not only experts in the medical field, but accomplished survivalists as well. Both Joe and Amy are certified Advanced Wilderness Expedition Providers.

What impact have the homeless encampments had on society from a health and sanitation standpoint?

Dr. Bones: Growing populations of homeless with lack of access to good sanitation are causing a resurgence of diseases that made headlines more than a century ago.

One notorious story of that era about typhoid related to a domestic servant known as “Typhoid Mary” Mallon. From 1900-1907, she worked as a cook for various families in New York City. She was a carrier of the microbe that caused Typhoid fever, which she transmitted to at least 50 people without feeling sick herself.

We call those who transmit disease without becoming ill themselves “vectors”. A mosquito is a vector for malaria: It passes the disease without having any symptoms.

The elimination of a vector from the environment (terminating Mary’s employment, for example) usually ends the outbreak of disease. This is exactly what happened when Mary Mallon was identified as the vector and quarantined for three years. When she returned to work as a cook for a women’s hospital in 1915, however, she caused a second outbreak that sickened 25 people.

What causes typhoid fever?

Typhoid fever is caused by Salmonella typhi, a bacterium found in contaminated and undercooked food and water. The illness it causes is called “Typh-oid fever” because it is often confused with a different epidemic disease (also circulating in Los Angeles) called “Typhus”.

Food poisoning with Salmonella occurs more often than with any other bacteria in the United States. The CDC reports that there are 22 million cases reported worldwide every year.

In typhoid fever, there is an incubation period averaging 8-14 days. After a gradual onset of high fevers over several days, abdominal pain, intestinal hemorrhage, weakness, headaches, constipation, and bloody diarrhea may occur. A number of people develop a spotty, rose-colored rash.

Are there stages to typhoid fever?

Typhoid fever seems to appear in four week-long stages:

Stage 1: The patient develops a high fever peaking in the afternoon, along with cough and headache. Some experience bleeding from the nose. A drop in the heart rate (bradycardia) is noted, which is an unusual finding in someone with a fever. Normally, a patient with a fever has a high heart rate (tachycardia).

Stage 2: Fever remains elevated, and, if untreated, the patient becomes delirious. Rose-colored spots appear on the lower chest and abdomen in around a third of patients. Foul-smelling green diarrhea that is reminiscent of pea soup is often seen in this stage. Weight loss occurs as the abdomen becomes distended due to an enlarged liver and spleen.

Stage 3: Damage to the intestines leads to bleeding or perforation of the wall. An infection of blood called “septicemia” occurs and the lining of the abdomen becomes inflamed (“peritonitis”). Blood clotting factors become depleted which may lead to more bleeding. The patient’s mental status worsens. 12-30 percent of untreated sufferers don’t survive beyond this point.

Stage 4: Fever slowly reduces in those that survive to the fourth week, but intestinal and mental effects may persist for months. The victim looks emaciated and may still harbor the organism as a “carrier.”

What can you share about the typical treatment of typhoid fever?

Treatment of Typhoid patients with Cipro, Azithromycin or certain other antibiotics, if given early, leads to a survival rate of 99%. Education in recognizing previously rare epidemic diseases in our disadvantaged populations is as important now as it was in the 19th century.”

Disclosure: This post has links to 3rd party websites, so I may get a commission if you buy through those links. Survival Sullivan is a participant in the Amazon Services LLC Associates Program. As an Amazon Associate, I earn from qualifying purchases. See my full disclosure for more.

One of Dr. Bones and Nurse Amy’s top selling books, Alton’s Antibiotics and Infectious Disease: The Layman’s Guide to Available Antibacterials in Austere Settings, is often cited as the definitive medical survival books every prepper should include in their self-reliance library.

The book is a simplified guide to using antifungal and antibacterial veterinary medications. It was written to aid non-medical professionals during a disaster, or when they find themselves in some type of survival situation where the application of modern medicine is not feasible.

In the book you will learn how to both acquire and use the noted medications safely. Dr. Bone’s points out that avian and aquatic antibiotics are essentially identical to human versions – and are available over the counter.

Perhaps my favorite part of the book, and the section most relevant to the 1800s era diseases covered in this article, is the portion which covers not only common, but uncommon infectious diseases that could easily impact your life during a SHTF event.

I thought Joe and Amy’s The Survival Medicine Handbook was a first place winner of the Book Excellence Award in Medicine. I thought it was going to be our tribe’s favorite go to reference, but now, it’s a toss up. I really wouldn’t want to be without either detailed reference book when the SHTF.

Typhoid Fever Treatment

Resistance to antibiotics has increased in the bacteria that causes typhoid fever, according to the Centers For Disease Control and Prevention – CDC.

If stricken people do not receive treatment or are resistant to the antibiotics prescribed, they can maintain a high fever for weeks or even months – along with other complications from the infectious disease.

The dangers posed by typhoid fever do not end when the initial presenting symptoms go away. You can carry the Salmonella Typhi or Salmonella Paratyphi bacteria in your body far into the future – potentially infecting other people you come into contact with, especially via food handling and when caring for your children.

When left untreated, typhoid fever can make the patient become delirious. It can also provoke what has been dubbed as the “typhoid state” where the stricken person lies in an exhausted and motionless state with their eyes half open.

Ciprofloxacin (Cipro) is the antibiotic most often prescribed in the United States for the treatment of typhoid fever. Ofloxacin is also a commonly prescribed medication for this condition.

As noted above, some strains of typhoid fever is no resistant to antibiotics. If Cipro is not working or the patient cannot take this prescription drug, Azithromycin (Zithromax) has been prescribed.

Ceftriaxone is an injectable antibiotic alternative that tends to be used in more severe in typhoid fever infections. It is also prescribed to patients who may not be able to take Cipro, like young children.

man with cholera


The same type of living conditions created by the homeless encampments in LA, San Francisco, and other major cities, that WILL occur during a SHTF cannot only spark a typhoid fever outbreak, but a cholera epidemic, as well.

During a cholera pandemic in India, more than 800,000 people – this was the sixth such pandemic the country faced from the 19th century through 1930.

To date, there have been seven global cholera pandemics. Every year, between slightly more than 1 million up to 4 million people around the world are stricken with cholera. Between 21,000 to 143,000 die as a result of the illness, according to the World Health Organization – WHO.

Although currently rare in the United States, cases of cholera still exist. A cholera epidemic in Hispaniola in 2010 causes 23 people to become stricken with the disease in the United States. On average, six cases of cholera per year are reported in America.

What Is Cholera?

The Vibrio cholerae cholera bacterium is typically found in food or water or sources that have been contaminated by feces from an afflicted person. Because cholera is most often found in locations that have poor water treatment systems and sanitation practices, outbreaks are not uncommon in Third World countries.

How long do you think any given city or small town to resemble a Third World country during a long-term disaster?

Out here, in the country, we rarely rely upon a municipal water treatment plant for our drinking water, we have wells, natural springs, and know how to make the water flowing in our rivers, creeks and in ponds potable. But that will not make us immune from the possibility of a cholera outbreak.

Our nearly pristine waterways will be subjected to all types of additional traffic and poor practices by folks fleeing the disaster. Also, the cholera bacteria is known to live in both coastal and brackish river water.

You can contract cholera by eating contaminated food or drinking contaminated water. During a cholera pandemic or epidemic, the typical contamination is sparked by the feces of a sick person coming into contact with a water source or food.

The illness will spread quickly anywhere the treatment of raw sewage or water goes is poor or non-existent. Cholera is not considered to likely ever be spread from casual person to person contact, like it occurs with the flu or common cold.

Cholera Symptoms

  • Very Watery Diarrhea
  • Leg Cramps
  • Vomiting

Approximately 10% of the people who contract cholera will garner a severe case of the illness. In such cases, the rapid loss of bodily fluids can lead to intense dehydration, followed by shock, and death within hours if no treatment is administered.

Cholera Treatment

To determine if a person has cholera, a doctor typically takes a rectal swab or a stool sample, and sends it off to a lab to be tested.

Patients are usually treated with an oral rehydration solution that is basically a mixture of salt and sugar mixed with water to replenish the fluids the body loses during the violent diarrhea the illness provokes. In more severe cases of cholera, intravenous fluid replacement is required.

In today’s society, fewer than 1% of cholera patients die after being diagnosed and treated for cholera. Prescribed antibiotics can decrease the severity of the symptoms.

girl with smallpox


Smallpox is an infectious disease that is caused by either Variola major or Variola minor. The World Health Organization declared it eradicated in 1980. Approximately 30 percent of the afflicted died from the disease.

The Centers For Disease Control and Prevention have stated that the variola virus that causes smallpox could be used on Americans during a biological attack. Such an attack would not only kill people, but the livestock and crops we need to sustain ourselves as well.

The public health centers are reportedly worried about smallpox being used as a biological weapon because some nation states made the virus into a weapon in the past, and only two virus research labs exist to study and combat the ultra-contagious and deadly threat.

The CDC operates one of the labs and the Russian State Centre for Research on Virology and Biotechnology, owns the other in the Russian Federation.

Babies and young children were the most susceptible to smallpox. Survivors were often left with mild to substantial scarring, especially on their faces. The disease also could cause blindness.

During the 20th century, about 300 million people died from smallpox. As recently as 1967, approximately 15 million people contracted the potentially deadly disease. During that same year the WHO ramped up efforts to develop an effective shot, and see it distributed around the world.

No one knows when smallpox originated, but cases of what was also once dubbed the “red plague” date back for centuries. The name smallpox came about to differentiate it from ongoing cases of syphilis in Britain in the 15th century – the syphilis outbreak was called the “great pox.”

Smallpox Symptoms:

  • Vomiting
  • High Fever
  • Headaches
  • Body Aches
  • Lethargy
  • Rash

Smallpox is not typically contagious until it reaches the third stage, when the telltale rash begins to appear. The rash often begins as small red dots in the mouth, and on the tongue. Then it morphs into sores or bumps that break open, and spread the virus around the mouth and into the throat – sparking a high fever in the process.

Next, the skin rash begins to appear, starting on the face and then spreading to the extremities. Sometimes, in less than 24 hours the rash has spread all over the entire body. The fever can decline as the rash spreads, sometimes the patient beginning to feel a lot better.

On about day 4, of cholera illness after the rash presents; the sores fill with a thick and opaque liquid which often has a dimple in the center. Once the sores fill up with fluid, the fever typically returns and can surge, until the bumps scab over.

The sores from the rash become sharply raised and firm to the touch, feeling like peas are present under the skin. It takes about 5 days for them to become crusty, and scab over throughout the body – the patient remains contagious at this time, as well.

In the next still contagious phase, the smallpox scabs fall off, and leave scarring on the skin. This process takes about 6 days. When all of the scabs have fallen off, which can take 4 weeks, the person is no longer contagious.

Smallpox Treatment

In the event of a smallpox outbreak, public health officials would use a shot to control it.

Once a patient has presented with the smallpox rash, the shot is powerless to curtail the disease. The shot must be taken before becoming ill, for the best results.

If it is taken within three days of exposure to smallpox, it could help prevent the disease from getting worse, according to the CDC. When inoculated between 4 to 7 days after exposure, it is likely the person will still get smallpox, but would not become as ill as a person who went without a shot.

While there are some antiviral drugs that may help either prevent or treat smallpox, there is currently no treatment available that has been proven effective in human smallpox patients.

Even though the WHO has deemed smallpox eradicated, the FDA is still engaging in lab tests to develop antibiotics to combat it. In July of last year, the FDA approved tecovirimat (TPOXX) for smallpox treatment.

The drug reportedly proved effective in testing conducted on animals that had diseases similar to smallpox. Tecovirimat has only been tried on healthy individuals in ongoing related laboratory trials.

Additional smallpox laboratory tests indicate that both cidofovir and brincidofovir could be effective against the virus that is known to cause smallpox. These drugs were also tested on animals with smallpox-like illnesses.

Both healthy people and those with various viral illnesses have also been a part of the testing process. Cidofovir and brincidofovir are still undergoing toxicity and effectiveness evaluations.

According to the CDC, even though testing on the medications mentioned above remains ongoing, using them to combat a smallpox outbreak might be considered. Cidofovir and Tecovirimat are currently stockpiled and stored as a part of the CDC’s Strategic National Stockpile.



Monkeypox is eerily similar to smallpox. It was discovered far more recently, in 1958. Two outbreaks happened at once in some colonies of monkeys that were being kept for research purposes. It was not until 1970, just a few years after smallpox was declared eradicated, that the first known case of monkeypox occurred in humans.

The case presented in Congo during the efforts to eliminate smallpox in the region had intensified. Many other cases in other regions of the world have followed.

Monkeypox is caused by infection with monkeypox virus. This virus belongs to the Orthopoxvirus genus – which also includes the smallpox-causing variola virus, and the vaccinia virus used in the smallpox shot.

The origins of the virus remain unknown, but researchers tend to think rodents from Africa played a role in its transmission. The symptoms of monkeypox are extremely similar but less severe than those of smallpox. Swollen lymph nodes, and intense chills are among the monkeypox symptoms that are uncommon in smallpox cases.

Monkeypox Transmission

Transmission of the virus occurs when a person comes into contact with the monkeypox virus from an infected animal, other human beings, or contaminated materials.

The monkeypox virus enters the body through even slightly broken sin, mucous membranes, and the respiratory tract. Animal to human transmission through a scratch or bite or contact with bodily fluids, such as during meat preparation.

Currently, there is no safe or proven treatment for monkeypox, according to the CDC. The virus can be controlled by using the smallpox shot, vaccinia immune globulin, and other prescription antivirals.

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