Typhoid & Paratyphoid

Transmission

Typhoid fever and paratyphoid fever are similar diseases caused by bacteria.

Salmonella Typhi bacteria cause typhoid fever.
Salmonella Paratyphi bacteria cause paratyphoid fever.

People infected with these bacteria can spread them to others.

It is more common in countries that have poor sanitation, poor hand hygiene and food handling standards and untreated drinking water.

The bacteria that cause typhoid and paratyphoid are found in the faeces (poo) of infected individuals and sometimes in their urine.

Typhoid and paratyphoid spread when people eat or drink food or water contaminated with faeces. Flies may transfer the bacteria to food, or the food may have grown in, been prepared in or stored in contaminated water.

Uncooked fruits and vegetables and shellfish should be avoided in less developed countries.

These infections are different to infections with other strains of Salmonella which usually causes gastroenteritis (gastro).

Symptoms

Typhoid and paratyphoid have similar symptoms, but paratyphoid is milder. The symptoms of both illnesses generally develop gradually, often appearing 1 to 3 weeks after exposure.

Symptoms include:	Sometimes, symptoms include:
fever abdominal pain headache constipation or severe diarrhoea rash feeling extremely tired muscle aches and weakness loss of appetite	nausea or vomiting nosebleeds cough confusion or delirium. swollen abdomen (tummy) enlarged liver or spleen

Symptoms of typhoid usually start 8-14 days after infection. Symptoms can show as early as 3 days or as late as 60 days after infection. Symptoms of Paratyphoid usually show within 1-10 days.

⚠️ If they are not treated, typhoid and paratyphoid can be fatal. It is important to speak to a doctor as soon as you have symptoms.

Most people recover fully over several weeks with treatment and symptoms usually stop in a week.

Some people even if they have no symptoms of illness continue to have bacteria in their faeces and/or urine for more than a year. These people are called carriers and can infect others.

Who is at Risk?

Typhoid and paratyphoid fever are most common in parts of the world where water and food may be unsafe and sanitation is poor. Travellers to Eastern and Southern Asia (especially Pakistan India, and Bangladesh), Africa, the Caribbean, Central and South America, and the Middle East are at increased risk for typhoid and paratyphoid fever.

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People visiting friends or relatives are more likely than other travellers to get typhoid fever because they may stay in the country longer, may be less cautious about the food they eat or the beverages they drink because they eat local food prepared in people’s homes, and may not think to get vaccinated before travelling.

Prevention

Travellers can get the typhoid vaccine. There is no vaccination available for paratyphoid.

Typhoid vaccines are only 50-80% effective, so care should still be taken eating and drinking to lower the risk of getting typhoid fever. As there is no vaccine that protects against paratyphoid fever, care is still required. For these reasons, it is s very important to take the following steps to prevent typhoid.

Choose food and drinks carefully	Wash your hands
Only eat foods that are cooked and served hot Avoid food that has been sitting on a buffet Eat raw fruits and vegetables only if you have washed them in clean water or peeled them Only drink beverages from factory-sealed containers Avoid ice because it may have been made from unsafe water Only drink pasteurised milk	Wash hands often with soap and water for 20 seconds, especially after using the bathroom and before eating If soap and water are not readily available, use an alcohol-based hand sanitiser with at least 60% alcohol Keep your hands away from your face and mouth

The Centers for Disease Control and Prevention (CDC) website includes details about water disinfection - here.

More Information

Discover more about Typhoid and Paratyphoid at the following sites:

🇺🇸 United States - Center for Disease Control & Prevention (CDC)

🇦🇺 Australia - Healthdirect

🇳🇿 New Zealand - Ministry of Health

🇪🇺 European - Centre for Disease Prevention & Control

🇬🇧 United Kingdom - Travel Health Pro

🏴󠁧󠁢󠁳󠁣󠁴󠁿 United Kingdom (NHS Scotland) - Fit to Travel

🇨🇦 Canada - Public Health Services

🌐 World Health Organization (WHO)

International SOS

General Travel Advice Disclaimer - here.