Typhoid

Typhoid (also called typhoid fever) is a serious gut infection caused by the bacterium Salmonella typhi. This can cause high fever, headaches, tummy pain, diarrhoea (runny poo), muscle pains and weakness. In severe cases, it can be fatal.

It's related to the bacteria that causes salmonella food poisoning. In Aotearoa New Zealand, most cases of typhoid are in travellers visiting or returning from the Pacific Islands or South Asia.

Most cases of typhoid occur from eating food or drinking water that has poo or wee in it from someone who has the illness. This can happen if an infected person doesn’t wash their hands properly after going to the toilet.

Typhoid can be spread through:

•  contact with contaminated water (eg, from sewage in it)
•  eating shellfish or fish from in areas of contaminated water
•  eating raw fish, shellfish, fruit or vegetables that have become contaminated by contact with an infected food-handler.

Sometimes people bring food back from overseas with the typhoid bacteria in it. Some people can be carriers and infect others without being sick themselves.

The incubation period (between when you come into contact with the bacterium and get sick) is usually 8 to 14 days but can be from 3 to 90 days. 

There's a milder version of typhoid called paratyphoid fever.

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

Common symptoms include:

• a persistent high temperature that gradually increases each day and can reach up to 39–40°C
• headache
• feeling sick
• not feeling like eating
• tiredness
• a rash made up of small pink spots on the central body
• tummy pain
• constipation
• diarrhoea.

Your healthcare provider 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).

Call Healthline on 0800 611 116 or see your GP if you're worried about typhoid fever.

If it's diagnosed and treated early, the infection is more likely to be mild and can be treated at home 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 get worse, see your healthcare provider 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, eg, internal bleeding or splitting of your digestive system, meningitis, inflammation or infection of other organs, or even death.

The danger from typhoid fever doesn’t end when symptoms disappear. Even if your symptoms go away, you might still be carrying Salmonella typhi.

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.

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.

People who are in jobs or places where typhoid could spread easily should stay away until they are told they are no longer infectious. Examples include people who handle food and teachers and children in schools and childcare centres.

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

There are 2 vaccines available in Aotearoa New Zealand that you can get from some GP surgeries and travel medicine clinics. They're not funded so you will have to pay for them.

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

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