Typhoid and paratyphoid

Overview

Typhoid and paratyphoid (milder form, shorter duration) are bacterial infectious diseases. They present with a constantly high fever, and disorientation is typical. The symptoms include diarrhoea (pea soup diarrhoea) and constipation, abdominal pain/headaches and tiredness. It’s a good idea to obtain medical advice for travellers and get the vaccination before travelling to a risk area. Good hygiene measures can also reduce the risk of an infection.

Symptoms

• Incubation period: 1-3 weeks
• Paratyphoid has a milder and shorter course than typhoid, and is almost always accompanied by severe diarrhoea
• Typhoid: diarrhoea can occur, but isn't typical
• First week of sickness
  • Fever (rising slowly)
  • Abdominal pain and headaches
  • Disorientation
  • Constipation
• Second and third weeks of sickness
  • Fever (constantly >38°C)
  • Pea soup diarrhoea and constipation
  • Fatigue/lethargy
  • Disorientation
  • Abdominal pain
  • Greyish-yellow coating on tongue
  • Skin rash on stomach/chest: small pink spots

Complications

• Intestinal ulcers, intestinal bleeding, possibly intestinal perforation (followed by peritonitis)
• Gallbladder inflammation
• Spleen rupture (owing to enlargement of spleen)
• Kidney damage
• Meningitis, myocarditis
• Sepsis

Causes and treatment

Cause

• Pathogen: typhoid and paratyphoid bacteria
• Human-to-human transmission (chronic germ carriers)
• Indirect transmission (human faeces)
  • Contaminated food (e.g. fertilising with manure)
  • Contaminated water
• Risk areas mainly include Africa, South-East Asia, South America

Further treatment by your doctor / in hospital

Possible tests

• Stool analysis
• Blood test

Possible therapies

• Antibiotics (compulsory)
• Further measures depend on symptoms

What can I do myself?

• When staying in a risk area (in particular Africa, South-East Asia, South America)
  • Medical advice for travellers at least 6 weeks before travelling
  • Vaccination is recommended (capsules given by mouth)
  • Good food hygiene (only cooked/peeled food)
  • Water: boiled or bottled
  • For detailed information, see "Tropical and travel diseases”
• Hand hygiene

When to see a doctor?

• Fever for several days during or after the trip
• Disorientation, possibly accompanied by headache
• Severe diarrhoea
• Blood in stool
• Unexplained skin rash
• Unexplained fatigue/lethargy for several days

Further information

Federal Office of Public Health, FOPH (Bundesamt für Gesundheit, BAG)
www.bag.admin.ch

Ostschweizer Infostelle für Reisemedizin (Eastern Switzerland Information Centre for Travel Medicine)
www.osir.ch

Swiss Tropical and Public Health Institute (Schweizerisches Tropen- und Public Health-Institut)
www.swisstph.ch

FDFA (travel links)
www.eda.admin.ch/eda/en

Synonyms

typhoid and paratyphoid, abdominal typhoid, typhia, typhoid fever, enteric fever