What are typhoid and paratyphoid fever?

Typhoid fever is caused by salmonella typhi bacteria. It can become life threatening if not treated.

Paratyphoid fever is caused by salmonella paratyphi bacteria.

Typhoid and paratyphoid fever are also known as enteric fever.

The bacteria are usually spread through food or water that is contaminated by faeces (poo) or urine (wee).

Typhoid fever and paratyphoid fever are most common in parts of:

• Africa
• Asia
• Latin America
• the Middle East
• the Pacific Islands

In Australia, fewer than 150 cases of typhoid fever are reported each year and the vast majority of these come from overseas travellers.

What are the symptoms of typhoid and paratyphoid fever?

Typhoid and paratyphoid fever have similar symptoms, but paratyphoid is milder. The symptoms of both illnesses generally develop gradually.

Typically, symptoms of typhoid and paratyphoid fever appear 2 to 3 weeks after exposure. Typhoid fever symptoms can vary from person to person.

The first symptoms are often:

• fever
• headache
• generally feeling unwell

Other symptoms can include:

• loss of appetite
• abdominal (tummy) pain
• constipation or diarrhoea
• rash — rose-coloured spots
• cough

Without treatment, the illness can last for 3 to 4 weeks.

Paratyphoid fever is clinically similar to typhoid fever but tends to be less severe.

What are the causes of typhoid and paratyphoid fever?

Typhoid and paratyphoid fever are caused by 2 different species of salmonella bacteria:

1. salmonella typhi (typhoid)
2. salmonella paratyphi (paratyphoid)

These bacteria live in urine or faeces. The bacteria can spread:

• by eating or drinking contaminated food or drink
• by touching infected surfaces such as taps, toilets, cutlery, toys and nappies
• from person-to-person — this is rare

Who is at risk of typhoid and paratyphoid fever?

People at risk of getting infected with typhoid and paratyphoid are:

• people who travel to areas where typhoid and paratyphoid are widespread
• preschool children
• young people aged from 5 to 19 years

When should I see my doctor?

If your doctor has diagnosed typhoid fever and you have sudden severe abdominal (tummy) pain or rectal bleeding (bleeding from your anus / back passage), call triple-zero (000) and ask for an ambulance.

See your doctor immediately if you develop a fever after returning from travelling overseas.

If you have typhoid fever and feel increasing pain anywhere in your body or feel that your symptoms are not under control, see your doctor urgently.

How are typhoid and paratyphoid fever diagnosed?

If you think you might have typhoid or paratyphoid fever, see your doctor straight away. They will examine you and may ask you about any recent overseas travel.

To diagnose the infection, your doctor may ask you to provide a sample of your urine or faeces, or refer you for a blood test to check for salmonella typhi and salmonella paratyphi.

Typhoid fever is a notifiable disease. This means that if you have typhoid fever, the lab will tell the local public health authority. They may ask to talk with you to try to find out where you caught typhoid fever.

How are typhoid and paratyphoid fever treated?

Typhoid fever and paratyphoid fever are treated with antibiotics. If you're very unwell you may need to go to hospital.

Without treatment, typhoid and paratyphoid fever can be life threatening.

To avoid dehydration, it's a good idea to drink:

• plenty of water
• oral rehydration solutions (rehydration drinks — available from the pharmacy)

Can typhoid and paratyphoid fever be prevented?

There are vaccines for typhoid, which provide some protection for travellers to high-risk countries. These can be given orally (by mouth) or by injection. There is no vaccine for paratyphoid fever.

Typhoid vaccination is recommended for all travellers aged 2 years and over going to areas where typhoid is present. It's also recommended for military personnel and some laboratory workers.

When travelling to developing countries, you can reduce your risk of infection by:

• eating only cooked or peeled food
• drinking only bottled or purified water
• avoiding ice in cold drinks
• avoiding food from street stalls
• regularly washing your hands with soap (or hand sanitiser), especially after using the toilet and before eating

Talk to your doctor about whether the typhoid vaccine is right for you.

What are the complications of typhoid and paratyphoid fever?

There are many complications of untreated typhoid fever. Complications typically arise in the third week of illness.

The 2 most common complications of untreated typhoid fever are:

1. bleeding in your digestive system
2. perforation (holes) in your digestive system (gut) — this spreads the infection

Other complications of typhoid fever include hepatitis, cholecystitis (gallbladder inflammation) and heart problems such as myocarditis (inflammation of the heart muscle) and endocarditis (inflammation of the inner lining of the heart).

Resources and support

Learn more about typhoid and paratyphoid fever in Australia at the Department of Health, Disability and Ageing.

For information on travel, you can:

• check if there is a typhoid fever risk in the country you are travelling to at Smartraveller
• learn more about travel vaccinations
• read tips on how to stay well during your holiday

For more information on immunisation in Australia, you can check:

• the National Immunisation Program Schedule
• the Australian Immunisation Handbook

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.