What are typhoid and paratyphoid?

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

Paratyphoid fever is caused by salmonella paratyphi bacteria.

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, more than 9 out of 10 cases of typhoid fever are caught overseas.

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 fever appear 8 to 14 days after exposure. Symptoms of paratyphoid fever appear 1 to 10 days 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 pain (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.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes typhoid and paratyphoid fever?

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

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

These bacteria are found in urine or faeces. The bacteria can be spread:

• by eating or drinking contaminated food
• by touching dirty 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

How are typhoid and paratyphoid diagnosed?

If you suspect 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.

A sample of your urine, faeces or blood will be tested for salmonella typhi and salmonella paratyphi.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

Typhoid fever is a notifiable disease. This means that if you have typhoid fever, the lab has to tell the local public health authority. They may ask to talk with you to try and 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 drinks such as Gastrolyte or Hydralyte

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

Typhoid vaccine

This table tells you more about the typhoid vaccine.

Who is the vaccine recommended for?	Typhoid vaccination is recommended for: military personnel laboratory staff who work with salmonella typhi travellers aged 2 years or older going to typhoid endemic regions
When to get vaccinated?	You should consult your doctor at least 6 weeks before you leave Australia.
How many doses are needed?	1 injection OR 1 capsule on days 1, 3 and 5 taken one hour before food
How is it administered?	Injection or orally. The oral vaccine can be used in people aged over 6 years.
Is it free?	No, the typhoid vaccine is not free. It is not covered by the National Immunisation Program Schedule.
Common side effects	The vaccine is very safe. There are very few side effects. Side effects with the capsules include: tummy discomfort, diarrhoea, nausea, vomiting or a rash. Side effects with the injection are: redness, swelling and pain at the injection site

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

Complications of typhoid fever and paratyphoid fever

There are many complications that can be caused by untreated typhoid fever. Complications typically arise in the third week of illness. About 1 in 10 people develop complications.

The 2 most common complications of untreated typhoid fever are:

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

Resources and support

To learn more about typhoid and paratyphoid fever in Australia, visit the Department of Health Communicable Diseases Network Australia.

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.