TYPHOID FEVER (1)

TYPHOID FEVER
PART A
Typhoid fever is a bacterial infection that can spread throughout the body, affecting many organs.
Without prompt treatment, it can cause serious complications and can be fatal.
It's caused by a bacterium called Salmonella typhi, which is related to the bacteria that cause
salmonella food poisoning.
Typhoid fever also known as enteric fever is highly contagious. An infected person can pass the
bacteria out of their body in their poo or, less commonly, in their pee.
If someone else eats food or drinks water that's been contaminated with a small amount of infected
poo or pee, they can become infected with the bacteria and develop typhoid fever.
How the infection spreads
The Salmonella typhi bacteria will be in the poo of an infected person after they have been to the
toilet.
If they don't wash their hands properly afterwards, they can contaminate any food they
touch. Anyone else who eats this food may also become infected.
Less commonly, the Salmonella typhi bacteria can be passed out in an infected person's pee.
Again, if an infected person handles food without washing their hands properly after peeing, they
can spread the infection to someone else who eats the contaminated food.
In parts of the world with poor sanitation, infected human waste can contaminate the water supply.
People who drink contaminated water or eat food washed in contaminated water can develop
typhoid fever.
Other ways typhoid fever can be contracted include:

 using a toilet contaminated with bacteria and touching your mouth before washing your
hands
 eating seafood from a water source contaminated by infected poo or pee
 eating raw vegetables that have been fertilised with human waste
 having oral or anal sex with a person who's a carrier of Salmonella typhi bacteria
How the bacteria affect the body
After eating food or drinking water contaminated with the Salmonella typhi bacteria, the bacteria
moves down into the digestive system, where they will quickly multiply.
This triggers a high temperature, stomach pain and constipation or diarrhoea.
Left untreated, the bacteria can get into the bloodstream and spread to other areas of the body.
This can cause the symptoms of typhoid fever to get worse during the weeks after infection.
PART B
SYMPTOMS
The symptoms of typhoid fever usually develop 1 or 2 weeks after a person becomes
infected with the Salmonella typhi bacteria.
With treatment, the symptoms of typhoid fever should quickly improve within 3 to 5 days.
If typhoid fever isn't treated, it'll usually get worse over the course of a few weeks, and
there's a significant risk of life-threatening complications developing.
Without treatment, it can take weeks – or even months – to fully recover, and symptoms
can return.
The main symptoms of typhoid fever are:
 a persistent high temperature that gradually increases each day

 a headache
 general aches and pains
 extreme tiredness (fatigue)
 a cough
 constipation
Later, as the infection progresses you may lose your appetite, feel sick and have a tummy
ache and diarrhoea. Some people may develop a rash.
Getting medical advice

See your GP as soon as possible if you have symptoms of typhoid fever (even if you have
been vaccinated against it), particularly if you have recently returned from travelling abroad.
It's unlikely that your symptoms will be caused by typhoid fever, but it's best to get them
checked out in case you need treatment.
PART C
DIAGNOSIS
PART D
VACCINATION
Vaccination against typhoid fever is recommended if you're travelling to parts of the world where
the condition is common.
High-risk areas
Typhoid fever is found throughout the world, but you're more likely to get it in areas where there's
poor sanitation and hygiene.
High-risk areas include:
 the Indian subcontinent
 Africa
 south and southeast Asia
 South America
Vaccination is strongly recommended if you're going to be staying or working with local people, or if
you're going to be staying for prolonged periods in areas where sanitation and food hygiene are
likely to be poor.
In the UK, most people who get typhoid fever develop it while visiting India, Pakistan or Bangladesh.
It's therefore particularly important that you're vaccinated if you're visiting these countries.
Typhoid fever vaccines
In the UK, the 2 main vaccines available to prevent typhoid fever are:
 Vi vaccine – given as a single injection
 Ty21a vaccine – given as 3 capsules to take on alternate days
Combined typhoid and hepatitis A injections are also available for people aged 15 or over. Protection
against hepatitis A lasts 1 year and protection against typhoid lasts 3 years.
The vaccines work by stimulating your body to create antibodies (infection-fighting proteins) that
prevent you getting ill if you become infected with the typhoid bacteria.
But neither typhoid vaccine is 100% effective, so you should always take precautions when eating
food and drinking water abroad.
As the Ty21a vaccine contains a live sample of Salmonella typhi bacteria, it isn't suitable for people
with a weakened immune system – for example, people with HIV and those receiving certain types
of treatment, such as chemotherapy.
It also isn't usually recommended for children under 5, whereas children can have the Vi vaccine
from 2 years of age.
It's unclear whether the Vi and Ty21a vaccines present a risk to pregnant or breastfeeding women.
But vaccination should be considered if there's a significant risk of getting typhoid fever.
The typhoid vaccine should ideally be given at least 1 month before you travel, although if necessary
it can be given closer to your travel date.
Booster vaccinations are recommended every 3 years if you continue to be at risk of infection with
typhoid bacteria.
Side effects of typhoid fever vaccine
After having the typhoid fever vaccine, some people have temporary soreness, redness, swelling or
hardness at the injection site.
About 1 in every 100 people have a high temperature.
Less common side effects include:
 abdominal pain
 headache
 feeling sick
 diarrhoea
Severe reactions are rare for both typhoid vaccines.
END OF PART A
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TYPHOID FEVER

How the infection spreads

Other ways typhoid fever can be contracted include:

 eating seafood from a water source contaminated by infected poo or pee

How the bacteria affect the body

This triggers a high temperature, stomach pain and constipation or diarrhoea.

The main symptoms of typhoid fever are:

 a persistent high temperature that gradually increases each day

Getting medical advice

High-risk areas include:

 the Indian subcontinent

 south and southeast Asia

 Vi vaccine – given as a single injection

 Ty21a vaccine – given as 3 capsules to take on alternate days

Side effects of typhoid fever vaccine

About 1 in every 100 people have a high temperature.

Less common side effects include:

Severe reactions are rare for both typhoid vaccines.

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