Typhoid

Typhoid is a highly contagious infection that can make you very ill. If you have symptoms of typhoid, you need to see a doctor urgently. Without immediate treatment, you can have serious complications and even die.

Key points

  • Typhoid is caused by the Salmonella typhi bacterium. It needs to be treated with an antibiotic. 
  • You are most likely to get typhoid from drinking water or eating food that has been contaminated by the typhoid bacterium. This includes eating shellfish from beds that have been contaminated by raw sewage (unprocessed poo).
  • You can also get the bacterium when changing nappies of children who have typhoid.
  • Typhoid is rare in New Zealand – usually less than 10 cases per 100,000 population per year; however, there has been an outbreak in Auckland in April 2017.1
  • Good basic hand-washing is one of the best means of protecting yourself.
  • Symptoms include a high fever developing over several days, headaches, general weakness and muscle aches. Stomach pain and constipation are also common but some people get diarrhoea.
  • With treatment, typhoid should improve in a few days. Without treatment, complications can be life-threatening.

What causes typhoid?

Typhoid (also called typhoid fever) is caused by the bacterium Salmonella typhi, which infects your gut and blood and causes a fever and other symptoms.

Typhoid bacterium easily passes from one person to another through stools (poo) or sometimes urine (wee), for example, if an infected person doesn’t wash their hands properly after going to the toilet.

If someone else eats food or drinks water that's been contaminated with the bacterium, they can develop typhoid.

The incubation period (between when you come into contact with the bacterium and get sick) is usually 7 to 14 days but can be from 3 to 60 days.

Some people can be carriers and infect others without being sick themselves.

There is a milder version of typhoid called paratyphoid fever.

Who is most at risk?

  • In New Zealand, typhoid is most often caught in the Pacific.2
  • Children and the elderly are more at risk of getting typhoid.

What are the symptoms of typhoid?

Symptoms include:

  • fever that develops slowly and can reach a temperature of up to 39–40°C
  • headache
  • feeling sick
  • not feeling like eating
  • tiredness
  • a rash made up of small pink spots on the trunk of your body
  • stomach pain
  • constipation
  • diarrhoea
  • confusion, such as not knowing where you are or what's going on around you.

How is typhoid diagnosed?

See your doctor as soon as you think you might have typhoid. Your doctor will ask if you have been overseas recently. They will also ask you to do a blood test and provide a sample of your stools (poo) or urine (wee).

What is the treatment for typhoid?

Typhoid is treated with antibiotics. If you have severe symptoms, such as persistent vomiting, severe diarrhoea or a swollen stomach, you will probably be admitted to hospital.

If your symptoms are milder, you can recover at home and should feel better in a few days.

If your symptoms get worse, see your doctor as soon as possible. They may give you a different type of antibiotic.

You need to stay off work so you don’t spread the infection. You can go back to work as soon as you feel better unless you work with food, young children, elderly people or people with poor health. If you do, you will need to do another stool sample to be sure the bacteria have gone.

Some people have a relapse about a week after they finish their antibiotics. If you start to feel sick again, see your doctor as soon as possible.

If you don’t get treatment straight away, you can develop complications, such as internal bleeding or splitting of your digestive system, meningitis, inflammation or infection of other organs, or even death.

What self-care can I do when I have typhoid?

It's important that you take all your antibiotics. Don’t stop when you start to feel well as you might get sick again. Also:

  • rest
  • drink lots of water
  • eat regular healthy meals.

Also, take care not to spread the infection, by

  • washing your hands regularly with soap and warm water
  • not touching or preparing food for other people
  • not sharing your towel, utensils or food.

How can I prevent typhoid?

To reduce your chances of catching typhoid, always wash your hands well after using the toilet and before preparing or eating food.

If you are travelling to one of the countries where the rates of typhoid are high, get a vaccination before you do. These countries are:

  • India, Pakistan and Bangladesh
  • most countries of South-East Asia
  • several countries of the South Pacific, including Papua New Guinea
  • Central and South America
  • the Caribbean
  • African countries
  • countries of the Middle East.3

Learn more

Typhoid fever NHS Choices, UK, 2015 
Typhoid and paratyphoid Better Health, Australia, 2017
Typhoid and paratyphoid fever Patient Info, UK, 2015 

References

  1. Paul UK, Bandyopadhyay A. Typhoid fever: a review Int J Adv Med. 2017 Apr;4(2):300-306. 
  2. Lane RJ, Holland D, McBride S, Perera S, Zeng I, Wilson M, Read K, Jelleyman T, Ingram RJH. Enteric fever in the Pacific: A regional retrospective study from Auckland, New Zealand Intern Med J. 2015 Feb;45(2):148–155.
  1. Typhoid and paratyphoid Better Health, Australia, 2017 
Credits: Health Navigator Editorial Team. Last reviewed: 04 Apr 2017