Typhoid and paratyphoid fever

Salmonella Typhi and Salmonella Paratyphi can be found in the blood, faeces (poo) and urine of infected people, depending on the stage of the illness. You become infected by ingesting the bacteria through your mouth.

This can be by ingesting water or food contaminated by sewage or food prepared by people who are carriers of the bacterium.

You can also get typhoid and paratyphoid fever if you come into contact with microscopic amounts of faeces and urine from an ill person. This may occur directly by close personal contact, or indirectly by touching contaminated surfaces such as taps, toilet flush buttons, toys and nappies.

Typhoid and paratyphoid fever affects the whole body, not just the digestive tract (or gut).

The start of symptoms for typhoid fever is gradual and may begin with increasing tiredness between 3 to 30 days (usually 8 to 14 days) after you have ingested the bacteria.

Symptoms can include:

• tiredness (lethargy)
• headache
• fever
• stomach pain
• constipation or severe diarrhoea
• rose coloured spots on the body
• weight loss.

Paratyphoid fever has similar symptoms, but the illness tends to be milder, with symptoms usually beginning 1 to 10 days after ingesting the bacteria.

There are other infections that have symptoms similar to typhoid and paratyphoid fever. Laboratory testing of a faecal, urine or blood specimen is necessary to confirm that symptoms are due to infection with Salmonella Typhi or Salmonella Paratyphi.

Typhoid and paratyphoid fever can be life-threatening without appropriate treatment. People with suspected or confirmed typhoid or paratyphoid fever should:

• Drink plenty of fluids such as plain water or oral rehydration drinks (available from pharmacies) to avoid dehydration. Dehydration is especially dangerous for babies and the elderly.
• Avoid anti-vomiting or anti-diarrhoeal medications unless these are prescribed or recommended by a doctor.
• Take antibiotics as prescribed by a doctor – these are usually required to relieve symptoms and to reduce long term carriage of the bacteria.

If you experience severe or prolonged symptoms you should visit a doctor.

• Do not go to work or school for at least 48 hours after symptoms have finished.
• People with typhoid or paratyphoid fever who work in a high risk setting, including health care, residential care or child care, or handle food as part of their job, will be contacted by their local public health unit to discuss extra precautions and testing that will be required before they can be cleared to return to work.
• Wash and dry your hands thoroughly after going to the toilet.
• Avoid preparing or handling food and drinks for other people in your household until at least 24 hours after your symptoms have finished. If you must handle or prepare food, thoroughly wash your hands beforehand to reduce the risk of spreading the infection to others.
• Immediately remove and wash any clothes or bedding contaminated with vomit or diarrhoea using detergent and hot water.
• After an episode of diarrhoea or vomiting, clean contaminated surfaces (for example benches, floors and toilets) immediately using detergent and hot water. Then disinfect surfaces using a bleach-based product diluted according to the manufacturer’s instructions.
• Clean carpet or soft furnishings contaminated with diarrhoea or vomit immediately using detergent and hot water and then steam clean.

When travelling

When travelling to developing countries, especially in Asia, the Pacific islands, Africa, the Middle East and Central and South America, you should avoid:

• salads and fresh fruit juices
• raw or cold seafood, including shellfish
• raw or runny eggs
• cold meat
• unpasteurised milk and dairy products (including ice-cream)
• ice in drinks and flavoured ice blocks.

Fruit that you peel yourself is usually safe. Remember – ‘cook it, boil it, peel it, or leave it’.

Use bottled water or disinfect water (by boiling, chemical treatment or purifiers) for drinking and brushing teeth.

Read more about healthy international travel (external site).

Is there a vaccine for typhoid and paratyphoid fever?

A typhoid fever vaccine is available and can provide some protection for travellers to high risk areas overseas. There is no vaccine for paratyphoid fever. See your doctor or travel medicine specialist at least 2 months prior to departure to see if any vaccinations or medications are recommended.