TYPHOID FEVER
What treatment is available?
What is typhoid fever?
Typhoid fever is caused by a bacterium
called Salmonella enterica serotype Typhi
(S. Typhi) (formerly known as Salmonella
typhi). Most infections originate from outside
Australia. It is common in developing
countries and is transmitted by
contaminated food or water. Children, older
people, and travellers are more likely to
contract it.
What are the symptoms?
The main symptoms of typhoid fever are
fever and chills, and later abdominal pain.
Less common symptoms include diarrhoea
or constipation, headache, cough, and
intestinal bleeding. Symptoms usually start
8 to 14 days after infection with the bacteria.
Some people have no symptoms.
How is typhoid fever spread?
Typhoid fever is spread through ingestion of
contaminated food or water. The food or
water would have been contaminated by an
infected person, even though this person
may not have symptoms. Infection is most
common in places with poor sanitation.
Typhoid is common in the Indian
subcontinent, in southern Asia, southern
Africa, Papua New Guinea and other Pacific
Island nations.
Who is at risk of infection?
Anyone can be infected but young children
and the elderly are more susceptible.
Travellers to areas where typhoid fever is
endemic are more likely to be exposed.
How is it diagnosed?
A diagnosis of typhoid is usually done by
laboratory testing of a faecal or blood
sample.
Health Protection Service
Population Health Division
Howard Florey Centenary House, 25 Mulley Street, Holder ACT 2611
Locked Bag 5005, Weston Creek ACT 2611
Phone: (02) 6205 2155 Fax: (02) 6205 1739
Email: cdc@act.gov.au
Web site: www.health.act.gov.au
Antibiotics are needed to treat typhoid fever.
The bacteria are often resistant to some
antibiotics (fluoroquinolones), especially if
they originated from the Indian subcontinent
or South-East Asia. Patients may need to
be treated in hospital, especially when the
bacteria have entered the blood stream
causing a blood infection (septicaemia).
Supportive or other therapy including
adequate hydration is also important.
Antibiotics are also required to treat infected
people who have no symptoms. Antibiotics
can help reduce the time a person is
infectious.
Should I be at work or school?
Children should be excluded from childcare
or school until cleared by their medical
practitioner. People with typhoid fever, or
who share a house with an infected person,
must not work if their work involves food
handling, or caring for children, sick people,
and the elderly. Prior to returning to work or
school cases and their contacts need to
have no symptoms and to be shown to no
longer carry the infection. This is proven by
having a number of faecal samples tested
that all show negative results.
How is it prevented?
Vaccination is an important measure to
prevent typhoid infection. Before you are
travelling to a country where typhoid is
common, you should consider being
vaccinated at least two weeks prior to
arrival. Your doctor will advise when
revaccination is required to maintain
immunity.
When travelling in developing countries,
people should avoid consuming risky food
and drinks. More specifically:
• Avoid uncooked foods, including fruit
unless it is able to be peeled;
• Avoid untreated water, including ice;
• Drink beverages only from sealed
containers;
• Wash hands often, especially after
going to the toilet and before eating or
handling food;
• If soap and water are unavailable, use
an alcohol-based hand gel (with at least
60% alcohol);
• Avoid eating from street stalls; and
• Ensure hot food is thoroughly cooked
and eaten while hot.
Need more information?
For more information on typhoid fever
contact your doctor or call the Health
Protection Service, Communicable Disease
Control Information Line during business
hours on (02) 6205 2155.
Communicable Disease Control Section
at the Health Protection Service is
responsible for the investigation and
surveillance of notifiable or infectious
conditions in the ACT in order to control or
prevent their spread in the community. This
includes the promotion of immunisation,
education and other strategies that help to
limit the spread of diseases.
Typhoid fever is a notifiable disease. Cases
notified to ACT Health are investigated by
Public Health Officers.
Acknowledgements
1. Heymann DL, 2008, Control of
Communicable Diseases Manual, 19th
edition.
2. Hohmann EL. Pathogenesis of typhoid
fever. 2011, updated 21 April 2012 [cited
2012]; Available from:
http://www.uptodate.com/contents/pathogen
esis-of-typhoid-fever
3. Hohmann EL. Treatment and prevention of
typhoid fever. 2011, updated 8 August 2011
[cited 2012]; Available from:
http://www.uptodate.com/contents/treatment
-and-prevention-of-typhoid-fever.
4. NHMRC, 2013. The Australian Immunisation
Handbook, 10th edition.
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© Australian Capital Territory, Canberra.
Updated August 2014
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