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Typhoid fever

What is typhoid fever?

Typhoid fever is a life-threatening bacterial infection that can affect organs throughout the body.

Typhoid fever is caused by the Salmonella typhi bacteria and is very contagious. Without treatment it can be fatal.

Typhoid fever is rare in the UK with around 500 cases a year, mostly among people travelling abroad to areas where the disease is common, such as Bangladesh, India and Pakistan.

How do people contract typhoid fever?

Typhoid fever is mainly passed on from food or drink contaminated with an infected person’s poo, though transmission from urine is also possible.

This transmission is possible from:

  • An infected person not washing their hands after using the toilet then handling food or drink
  • Touching surfaces and handles used by an infected person
  • Seafood from contaminated waters
  • Raw vegetables that have been in contact with human waste
  • Contaminated milk
  • Oral or anal sex with an infected person

Some people carry typhoid with no symptoms, but may still pass it on.

What are the symptoms of typhoid fever?

Once they get into the digestive system the bacteria multiply. Usually symptoms start 1-2 weeks after infection, so you may be home from holiday before feeling unwell.

If the infection is not treated, it can get into the bloodstream, causing further symptoms and the risk of complications.

Typhoid symptoms include:

Complications of typhoid can cause:

  • Digestive system internal bleeding
  • Perforated bowel or digestive system spreading infection to nearby organs and tissue (peritonitis)

Typhoid diagnosis

Diagnosis of typhoid will be based on a person's symptoms, and if they are in the UK, any recent travel abroad.

If typhoid is suspected, a doctor will arrange blood, urine or poo sample tests.

These tests can be inconclusive, and may need to be repeated, or less commonly backed up with a bone marrow test.

If a typhoid diagnosis is confirmed family members, partners or people sharing the same home will need to be tested in case it has been passed on to them.

Extra home hygiene measures are needed during treatment, including thorough hand washing after using the toilet and when preparing food, to avoid spreading the infection.

How is typhoid fever treated?

A course of antibiotics is the main treatment for typhoid fever.

Some strains of the bacteria have become resistant to some antibiotics, so the results of the laboratory tests can help identify the type so that appropriate antibiotics can be used.

Symptoms should start to feel better within a few days of treatment starting.

You should stay off work until symptoms have gone. Under-5s, older people and those with other health conditions may need additional tests to check the infection has been cleared before going back to school or work.

It is also important to rest, eat regular meals and drink enough fluids to help recovery.

In severe cases of typhoid, admission to hospital may be needed. Antibiotics will then usually be injected or given through an IV drip.

Even after symptoms have gone, some people can remain carriers of typhoid, so follow-up tests will be arranged to check this. Additional, and longer, antibiotic treatment may be advised.

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