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Typhoid

What is Typhoid? 

Typhoid is a bacterial infection of the digestive tract, caused by gram-negative bacillus Salmonella typhi. It is spread by faecal-oral route via contaminated food and water from an infected human carrier. Typhoid is often transmitted by person-to-person contact, especially via food handlers. Incubation is 1-3 weeks and is rare under 2 years of age. 

Symptoms usually appear over the course of a month, with headaches and lethargy progressing to myalgia and abdominal discomfort. Some patients show a 'rose spot' rash after the first week of infection. Constipation can occur followed later by bloody diarrhoea with rigors. Patients remain infective for 6 weeks to 3 months after infection. 

Who is at risk of Typhoid? 

Typhoid is present in South America, Africa and areas of Asia, with undeveloped areas being of a higher risk. Cases can potentially occur throughout the world due to the mode of transmission and speed of travel. Natural disaster and imported cases allow for sporadic cases in parts of the world that would be considered low risk areas.

How can I prevent Typhoid? 

Vaccination (injectable or oral) for risk areas and occupational risk should be considered. Vaccination against both Hepatitis A and Typhoid combined is also available for travellers, as the two diseases have a similar epidemiology and share some transmission routes. As vaccination does not offer 100% protection, avoiding potentially contaminated food and drink is essential.