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Disease

Typhoid

Page last updated on 30 September 2019

Typhoid fever is a bacterial infection of the intestinal tract and bloodstream. Almost every Australian case is acquired during overseas travel, where individuals may consume contaminated food or water in countries where there may be unsafe water supplies and/or poor sanitation.

Symptoms and signs include diarrhoea, fever, tiredness, enlarged spleen and liver, and characteristic skin rash. Without prompt medical treatment, typhoid can be fatal. 

Key disease information

What is typhoid?

Typhoid fever is a bacterial infections of the intestinal tract and bloodstream. The bacterium responsible for both is Salmonella typhi, and is only carried by humans.

How is typhoid spread?

An infected person has the bacteria in their faeces and occasionally in their urine. Due to poor hygiene (hand-washing practices), the infected person may spread the bacteria from their hands to surfaces and objects that may then come into contact with food or be touched by other people.

Contamination can also occur when changing the nappy of a child with the infection. Water sources that are contaminated with infected faeces are another common way that the infection is transmitted.

Without treatment, about 1 in 20 people who recover from typhoid fever becomes an ongoing ‘carrier’ of the bacterium. Despite having no symptoms of the illness, they have bacteria in their faeces and urine, which can go on to infect others for a period of about three months (sometimes up to one year).

Is typhoid contagious?

Yes. The transmission if typhoid usually occurs when contaminated food and water are ingested. The time between contracting typhoid and the onset of symptoms (known as the incubation period) is usually around 8 to 14 days, however it can be shorter or longer. 

Because it is transmitted via food and water, in general, typhoid is more common in less developed countries with poor sanitation, poor food handling standards and unsafe drinking water. Shellfish as well as raw fruits and vegetables are the types of foods most often associated with illness, and flies may also help with transfer of bacteria to food. 

Is typhoid deadly?

Without prompt medical treatment, typhoid and paratyphoid fevers can be fatal. 

What are the symptoms of typhoid?

Symptoms and signs of typhoid range from mild to severe and last for about one month. Symptoms may include:

  • fever
  • fatigue or tiredness
  • malaise (general feeling of feeling unwell)
  • sore throat
  • persistent cough
  • severe headache
  • slower than usual heart rate
  • sweating
  • abdominal pains
  • changes in bowel habits, such as constipation or diarrhoea
  • lack of appetite and weight loss
  • reddened skin rash on the chest and stomach
  • mental changes such as confusion
  • blood poisoning (septicaemia)
  • enlarged spleen (splenomegaly)
  • enlarged liver (hepatomegaly).
How long can typhoid stay in the body?

The bacterium can remain in the body for a period of approximately 3 months, sometimes more than a year (although this is uncommon and usually in those people who have had no treatment). About 2-5% percent of carriers are permanently infectious. 

How can typhoid be prevented?

Australians can be vaccinated against typhoid before travelling overseas. 

Travellers are advised to visit their General Practitioner or travel medicine specialist six to either weeks before travelling overseas to discuss suitable vaccination options.

Australians travelling in countries with increased risk of typhoid should always take extra caution to avoid contaminated food and drinks. Travellers should always drink bottled water and where possible avoid ice in drinks. Raw foods like salad and fruits that can’t be peeled should also be avoided in case of water contamination. 

See you doctor to speak about prevention of typhoid fever. 
 

Which countries are affected by typhoid?

Typhoid may occur anywhere in the world, but is most prevalent in developing countries where there may be unsafe water supplies and/or poor sanitation, including: 

  • 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.
     

VaccineHub offers general information only. Please see a healthcare professional for medical advice

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Sources & Citations

  1. Victoria State Government. Better Health Channel. Typhoid and paratyphoid. Available at: https://www.betterhealth.vic.gov.au/health/HealthyLiving/typhoid-and-paratyphoid (accessed 15 April 2018).
  2. New South Wales Government Health. Typhoid and paratyphoid fact sheet. Available at: http://www.health.nsw.gov.au/Infectious/factsheets/Pages/typhoid.aspx (accessed 15 April 2018).
  3. Australian Government. Department of Health. The Australian Immunisation Handbook 10th Edition. 4.21 Typhoid. Available at: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-21 (accessed 14 April 2018).
  4. National Notifiable Disease Surveillance System. Number of notifications of all diseases received from State and Territory health authorities, 2017. Available at: http://www9.health.gov.au/cda/source/rpt_2.cfm (accessed 24 April 2018).

SPANZ.SAPAS.18.04.0143 - Date of preparation May 2018

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