The disease is caused by the bacteria Salmonella Typhi and Salmonella Paratyphi A, B or C. Typhoid is transmitted by food and drink that has been contaminated with human faeces or urine (faecal-oral route).
Typhoid can be found throughout the world but it is more common in countries where water or food supplies are liable to be contaminated with human excreta especially in Africa, the Indian Sub-continent, South East Asia and South America.
Typhoid causes systemic infection which may present as fever, headache, confusion and vague abdominal pain. Constipation is common in adults. Salmonella Paratyphi causes a milder illness than that of Salmonella Typhi.
Treatment with an antibiotic is usually required. Medical attention should be sought for any feverish illness experienced whilst travelling abroad.
Recommendations for Travellers
Prevention is focused on ensuring safe food and water, particularly in countries where typhoid is more common. Foods to be wary of include shellfish, salads, unwashed fruit and vegetables and raw undercooked meat products.
Good personal hygiene is also very important. Individuals should ensure that they wash their hands prior to eating and after using the toilet.
Various vaccines that protect against typhoid are available: Typherix, Typhim Vi and and an oral preparation (3 capsules) called Vivotif. A single dose of injectable vaccine protects for three years, but will not protect against para-typhoid fever. There are two vaccines that combine typhoid with hepatitis A for convenience: Hepatyrix and ViATIM. Individuals should consider being vaccinated if they are travelling to a country where typhoid fever is more common and where they will be unable to take sufficient care with food and drink.
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