Typhoid fever

Typhoid fever is a bacterial infection that can make you very ill and is very easy to pass on to others. It is relatively rare in Aotearoa New Zealand. Most cases are in people returning from overseas, especially from the Pacific and South Asia. Without quick treatment, it can make you very ill or cause death.


How typhoid fever spreads

You are most likely to get typhoid from eating food or drinking water that has the poo (faeces) or wee (urine) of someone who has the illness in it.

Typhoid is more common in developing countries. You can become infected through contact with contaminated:

  • water with sewage in it
  • shellfish from beds with sewage in them
  • raw fish, fruit and vegetables.

Sometimes people bring back food from overseas that has the typhoid bacteria in it.


Symptoms of typhoid fever

Symptoms of typhoid usually start 8 to 14 days after you have caught it. But, it can be up to 60 days later. 

Common symptoms include:

  • a high temperature (39°C to 40°C)
  • feeling cold and shivery (chills)
  • stomach pain
  • tiredness
  • headaches
  • loss of appetite
  • hard poos (constipation) in adults
  • runny poos (diarrhoea) in tamariki
  • muscle aches
  • a rash of small pink spots.

You may be infected and have no symptoms, but you can still pass typhoid on to others.


Diagnosing typhoid fever

If your healthcare provider thinks you have typhoid they will need a poo or blood sample for testing. 

Testing is free and your healthcare provider will let you know what you need to do. 

The role of public health

Typhoid is a notifiable disease. This means that healthcare providers or laboratories will inform public health when someone has it. This way we can:

  • monitor how many people are sick
  • contact people you have been in contact with and arrange for testing of their poo
  • give advice on how to reduce its spread.

Treating typhoid fever

If you are confirmed as having typhoid you will be treated with antibiotics to clear the infection from your body.

If left untreated, typhoid can have serious complications, including death.

If you are diagnosed and treated early you may be able to recover at home. If your symptoms are severe you may need to go to hospital.

Around 1 in 10 people become unwell again after they have finished their antibiotics. If this happens they need more.

Around 1 in 100 people do not respond to treatment and continue to carry the bacteria in their body. They may require long term antibiotic treatment to get rid of the infection.


Reducing the risk to others

Typhoid is highly infectious. If you have typhoid you should stay away from school, early childhood centres or work until 2 days after the symptoms have stopped.

High-risk places

There are some high-risk places where typhoid can spread very easily, such as:

  • workplaces that handle food or drinks
  • health and aged care facilities
  • schools and early childhood centres.

People can only return to high-risk places if they have:

  • completed their treatment with effective antibiotics
  • had no symptoms for at least 48 hours
  • 2 follow-up tests after being symptom free, at least 48 hours apart.

These will check you are no longer infectious and reduces the risk of you passing typhoid to others.

If you are not treated with antibiotics, you will need to wait until 1 month after your symptoms began and then complete testing.

Others you live with or have travelled with

Depending on where you were potentially infected, people you live with or travelled with may also need to be tested and excluded if they work in a high-risk job or attend day care or school.

A health professional will provide information to you and your whānau on this if required. These people will be contacts.


Preventing typhoid fever

Vaccines

There are 2 vaccines in Aotearoa New Zealand that reduce the chance of getting typhoid fever. They are not free. You can get them from some general practitioners and travel medicine clinics.

Good hygiene

Wash your hands with soapy water for 20 seconds, then dry well with a clean cloth or paper towel every time:

  • after going to the toilet
  • before preparing food, eating or drinking
  • after changing nappies.

Be careful around pēpi and tamariki, especially if they are in nappies.

Preventing the spread of food and water borne diseases (internal link)

Travel advice to prevent typhoid fever

If you are travelling to countries where typhoid is more common you can reduce your risk of infection.

  • Avoid unsafe drinking water, including ice and drinks mixed with water.
  • Only drink bottled water and boiled water.
  • Avoid food from street stalls.
  • Make sure hot food is well cooked and eat it while it is hot.
  • Avoid uncooked and raw food, including fruit and vegetables, unless you are able to wash, prepare and peel them yourself.
  • Avoid raw (unpasteurised) milk or dairy products.