Typhoid fever is a highly contagious tropical illness caused by a bacterium called Salmonella Typhi. It can cause serious complications without treatment and can sometimes be fatal. If you’re travelling to somewhere that has widespread typhoid fever, it’s recommended that you get a vaccination.

In this article we’ll share more about typhoid fever and its symptoms, as well as how to get a vaccine in the UK.

What is typhoid?

Typhoid fever is a serious infection that is spread through bacteria known as Salmonella typhi, similar to the bacteria that causes food poisoning. It is easily spread through contaminated water or food and affects between 11-20 million people every year.

Tropical illnesses such as typhoid fever are less common in the UK, where only 300 infections are confirmed each year. However if you are travelling abroad, you should find out if your destination has a higher rate of infection. It is most commonly found in India, Asia, Africa and South America as well as other countries with limited access to clean water.

How can you contract typhoid?

Someone with typhoid fever can easily pass on the infection. The bacteria is spread through poo or, sometimes pee, that can contaminate food and water though poor sanitation. If an infected person handles food without washing their hands after going to the toilet, they can spread typhoid fever onto others. Or if someone uses the same restroom and doesn’t wash their hands, they may catch the infection.

Infected human waste can also contaminate the water supply in parts of the world with limited sanitation. This can be spread through drinking water, washing food or eating seafood from a contaminated water source.

Washing your hands is vital in protecting yourself against typhoid fever. Make sure to use antibacterial hand wash and clean both the back and front of your hands for at least 20 seconds.

Symptoms of typhoid

The symptoms of typhoid fever usually appear within 1 to 2 weeks after contracting the infection. With treatment they will improve after 3 to 5 days but can last weeks or months without antibiotics.

The main symptoms of typhoid are:

A fever or high temperature
Headache
Body aches and pains
Fatigue
Coughing
Constipation or diarrhoea
Nausea and tummy ache
A rash

How is typhoid treated?

Typhoid fever is usually treated with antibiotics at home, however you may need to go to hospital if symptoms become severe.

If diagnosed in the early stages, a course of antibiotic tablets may be prescribed for 7 to 14 days. This should see symptoms improve within 5 days.

A blood, poo or pee sample will also be taken to determine the strain of Salmonella typhi bacteria causing the infection. Some strains are more resistant to antibiotics, therefore you may also need an injection.

General care should also be taken to recover from typhoid fever including plenty of rest and eating regular meals. You should stay hydrated by drinking plenty of fluids, or consider taking rehydration treatments. If your symptoms start to get worse or new symptoms appear, contact your GP as soon as possible.

Even after you feel better, you should continue to regularly wash your hands and practice good personal hygiene to reduce the risk of spreading typhoid fever to others. Don’t prepare food for others and ensure your doctor tests for remaining bacteria before getting back to normal.

Typhoid fever vaccines

A vaccine for typhoid fever is recommended if you are travelling to a high-risk area including Asia, Africa, India and South America. This is particularly the case if you will be in an area of poor sanitation for an extended period of time.

Types of typhoid vaccine

There are two main types of vaccines for typhoid fever in the UK:

Vi vaccine (single injection for aged 2 years and over)
Ty21a vaccine (3 capsules taken on alternate days for aged 5 years and over)

Each vaccine helps to protect your body from typhoid for a limited amount of time by stimulating the production of antibodies that help your body to fight the infection.

The Ty21a vaccine contains a live sample of Salmonella typhi bacteria and is therefore unsuitable for those with a weaker immune system or on certain types of treatment. It is also only suitable for children over 5 years of age.

It’s important to remember that neither vaccine is 100% effective therefore you should take precautions such as only drinking bottled water and avoiding food prepared in areas with poor sanitation.

How long does the vaccine last?

You should have a typhoid fever vaccine at least 1 month before you travel. It will then last for up to 3 years, at which point you should have a booster vaccination if you continue to be in a high-risk area or are planning to travel again in the future.

Side effects of the typhoid vaccine

Having the typhoid vaccine may cause temporary side effects caused by the antibodies of the Salmonella typhi bacteria.

This may include:

A high temperature
Headache
Nausea
Diarrhoea
Abdominal pain

The area where you had the injection may also feel sore, swollen, hard or red for a short amount of time. Taking pain relief before the injection may help, there’s also Emla cream which can temporarily numb the area, and dressings for afterwards. You can also take sickness tablets afterwards to reduce potential nausea.

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Countries that have typhoid

Typhoid fever is a global tropical illness however is more common in parts of the world with poor sanitation and hygiene.

This includes:

India, Bangladesh and Pakistan
Most of south and southeast Asia
African countries
Some areas of South America including Papua New Guinea
The Middle East

Where can I get the typhoid vaccine?

There are many different places in the UK that offer vaccinations for typhoid fever. You can usually receive it on the NHS via your GP or you can book a private appointment at a time that suits you.

Extra tips to prevent typhoid

A vaccination will help to prevent typhoid fever but doesn’t guarantee full protection. Reduce your risk of contracting an infection by following the below tips:

Drink bottled water that is properly sealed
Only drink pasteurised milk and avoid raw milk products
Avoid ice in drinks
Boil water or disinfect water with a disinfectant from a pharmacy
Wash and peel food including fruit and vegetables
Clean your hands thoroughly after going to the toilet, touching animals or others e.g. after shaking hands
Avoid potentially contaminated foods such as seafood and salads

In summary, typhoid fever is a serious tropical illness that is contracted from the bacteria, Salmonella typhi. It's prominent in Africa, India, South America and parts of Asia including China, and can be fatal if left untreated. If you have a high temperature, headaches, fatigue or constipation you should see a doctor immediately. Antibiotics are the most common treatment, but a vaccine is the best way to protect yourself against typhoid fever.

Find out more about travel vaccinations and how to protect yourself from other tropical diseases including malaria. You can also discover more tips and advice on the best insect repellents as well as the other travel essentials you’ll need for your trip.

References

www.who.int/news-room/fact-sheets/detail/typhoid

www.nhs.uk/conditions/typhoid-fever
www.cdc.gov/typhoid-fever/prevention.html