Typhoid and paratyphoid fever

Typhoid and paratyphoid fever are infections caused by the bacteria Salmonella Typhi and Salmonella Paratyphi. These infections are mainly seen in people who have travelled overseas to places with poor sanitation, such as parts of Africa, Asia, South and Central America and the Middle East. Infections acquired in Australia are rare. Read more about healthy international travel. How do you get 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 taking in the bacteria through your mouth. This can be by drinking water or eating 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. What are the signs and symptoms? Typhoid and paratyphoid fever affects the whole body, not just the digestive system. 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 taken in 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 taking in the bacteria. How do I know I have typhoid or paratyphoid fever? 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. How are typhoid and paratyphoid fever treated? 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 visit a doctor. What do I do if I have typhoid or paratyphoid fever?  Do not go to work or school for at least 24 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 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. How can typhoid and paratyphoid fever be prevented? 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. 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. Where to get help  See your doctor