Typhoid

Last updated: 27 November 2007

What is Typhoid?

Typhoid is caused by an infection with bacteria called Salmonella Typhi. In Australia, most typhoid infections are acquired overseas and occur after eating contaminated food or water in countries where typhoid is common. This infection is not the same infection with Salmonella.

What are the symptoms?

People infected with typhoid may experience mild or severe symptoms. The symptoms of typhoid fever may include fever, headache, general discomfort, lack of appetite, and a dry cough. The heartbeat slows and the spleen enlarges. Some people get rose spots on the trunk of the body. Constipation or diarrhoea may occur. Symptoms start 1 to 3 weeks after infection. Some people do not have any symptoms.

How is it spread?

In Australia, typhoid is usually acquired in developing countries such as Indonesia and countries of the Indian subcontinent. Most people get typhoid fever by eating or drinking food or water that has been contaminated by people with the disease, including by those who do not have any symptoms. Raw fruits and vegetables, milk, and shellfish are the types of foods most often associated with illness.

Who is at risk?

Everyone can be infected with typhoid, however there is a vaccine available and travellers to countries where typhoid is common should be vaccinated. Travel advice is available from the Centers of Disease Control.

Household contacts, or people who have travelled with a person infected with typhoid, will be screened for typhoid by their local public health unit. Contacts should be aware of the symptoms of typhoid and should see their general practitioner if they develop symptoms.

How is it prevented?

People travelling in developing countries should be vaccinated prior to travel and:

• avoid uncooked foods, including fruit unless it is able to be peeled
• avoid untreated water, including ice
• drink beverages from sealed containers
• wash their hands after going to the toilet and before eating
• avoid eating from street stalls
• ensure hot food is thoroughly cooked and eaten whilst hot.

Vaccination is not recommended for travel in Australia.

People infected with typhoid, or who share a house with someone infected with typhoid, MUST NOT work if their work involves food handling or caring for children, patients or the elderly, and should not prepare food for others. A number of stool tests will be required to assess when you are no longer infected with typhoid. Your local public health unit will advise you when are able to return to work.

People who have been potentially exposed to the same source, for example overseas travel, will also be advised not to work if their work involves food handling or caring for children, patients or the elderly. They will also need their stools tested.

Because typhoid can be carried on the hands it is very important to always wash hands thoroughly after using the toilet and before preparing food. Hands should be washed with soap and water for at least 15 seconds, rinsed and dried well.

How is it diagnosed?

To diagnose typhoid, your general practitioner or local hospital will send a blood or stool sample to a laboratory for testing.

How is it treated?

People with typhoid may require hospitalisation and will need antibiotics for treatment. Some people may never have symptoms but may be carriers of typhoid. Antibiotic treatment is required to treat carriers also.

What is the public health response?

Doctors, hospitals and laboratories must notify cases of typhoid to the local public health unit.
• Public health unit staff will interview the doctor or patient (or carers) to find out how the infection occurred.
• The NSW Food Authority, in collaboration with NSW Health, is responsible for the environmental investigation of food handlers with typhoid.
• Your local public health unit can advise further regarding exclusions from work and school. People excluded from work will need to have a number of stool tests done before they are allowed to return to work.

Related links

• Travelers' Health (CDC)  http://wwwn.cdc.gov/travel/default.aspx