Typhoid and paratyphoid are infections caused by the bacteria Salmonella Typhi or Salmonella Paratyphi.
They cause very similar diseases collectively known as enteric fever. It can be life-threatening unless treated promptly with antibiotics. The disease can last up to several weeks. If treated most people will make a full recovery however if untreated death rates can be high.1
Typhoid is spread through ingestion of food or water which is contaminated by faeces or urine from an infected person. If an infected person handles food without washing their hands properly after going to the toilet, they can spread the infection to someone else who eats the contaminated food.
In areas with poor sanitation, infected human waste can contaminate the water supply. People who drink contaminated water or eat food washed in contaminated water can develop typhoid fever.
Typhoid fever can be spread by:
Up to 1 in 20 people who survive typhoid fever without being treated will become carriers of the infection. This means the S. typhi continue to live in the carrier’s body and can be spread as normal in faeces or urine, but the carrier does not have any noticeable symptoms of the condition.2
Typhoid fever is commonly found in parts of the world that have poor sanitation and limited access to clean water.
Worldwide, children are thought to be most at risk of developing typhoid fever. This may be because their body’s natural defence against germs is still developing. However, children with typhoid fever tend to have milder symptoms than adults.
In 2016, the global annual rate of typhoid fever was estimated to be around 11.8 million cases with 128,000 deaths per year.3
The areas with the highest rates of typhoid fever and paratyphoid fever are:
A summary map can be found here.4
Symptoms of typhoid fever:
The incubation period is usually between 7-14 days, but can be as short as three days, or as long as 30 days. Symptoms vary from mild to severe and life-threatening and may include:
Symptoms of paratyphoid fever:
Paratyphoid fever is similar to typhoid; but it tends to come on more quickly, has milder symptoms, and lasts for a shorter time.5
Common complications include:
These may be life-threatening and may require a surgical operation.6
Other possible complications include:
If experiencing headache, fever, stomach pains, cough or diarrhoea then seek medical advice promptly. This is regardless of the vaccination status as vaccination does not guarantee complete protection.7
Typhoid fever can usually be successfully treated with a course of antibiotic medication. Hospital admission is only required for severe cases.
Treatment at home
The spread of typhoid can be minimised by:
Remember: BOIL IT, COOK IT, PEEL IT OR FORGET IT!
People who are recommended to have the vaccine are:
Vaccination is sometimes advised for travellers visiting lower risk areas if they are:
A previous typhoid illness does not necessarily mean a person will be immune, vaccination is still recommended.
In the UK, there are two types of immunisation against typhoid:
The typhoid vaccine requires booster vaccinations every 3 years if regularly travelling to at risk areas.
Combined typhoid and hepatitis A vaccinations are also available for people aged 15 or over. Speak to the pharmacist for more detail regarding this.12
The vaccine is not 100% effective and therefore travellers are advised to use precautionary measures such as regular hand washing, avoiding potentially contaminated food and drinking boiled or bottled water.9
For paratyphoid fever, food and water precautions are the only prevention method, as no vaccines are available.13
This information is taken from trusted third party websites, NaTHNaC (Travel Health Pro) and EMIS (Patient info) and use of all information has been licenced under the Open Government Licence http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.
Although the materials are being used/replicated under the provisions of the Open Government Licence this in no way represents endorsement of Traveljab.co.uk by NaTHNaC, Emis, Public Health England, the NHS or the Department of Health and Social Care.