Typhoid Update: A Guide for Travelers

Typhoid fever is a bacterial infection of the digestive system caused by Salmonella typhi.It can be a life threatening illness and is common in developing countries throughout the world, many of which are visited by travelers who are on vacation or business. Typhoid affects about 12.5 million people each year; however, it can be prevented with vaccination and can usually be treated with antibiotics. If you plan to travel, you should know about typhoid fever and what you can do to protect yourself from it.

How is typhoid fever spread?

Salmonella typhi is a bacterium that is only found in humans. Persons with typhoid fever carry the bacteria in their blood stream and intestinal tract; some recover from the illness, but still carry the bacteria. Both the sick person and the carrier shed S. typhi in their stool. One may contract typhoid fever if he/she ingests food or beverages that have been handled by an infected person, or if contaminated sewage is introduced into the water supply that is used for drinking or for washing food. Therefore, the disease is more common in areas of the world where hand washing is less frequent and the water sanitation is poor. Once S. typhi bacteria are eaten or drunk, they multiply and spread into the blood stream. The body reacts with fever and other signs and symptoms.

Where is Typhoid Fever?

Typhoid fever is common in most parts of the world except in industrialized countries such as the United States, Canada, western Europe, Australia, and Japan. If you are traveling to any other country, you should consider taking precautions. The Centers of Disease Control (CDC) reports an increased risk to travelers going to Asia, Africa, and Latin America.

How to Avoid Typhoid Fever

First, avoid risky foods and drinks. "Boil it, cook it, peel it, or forget it." Drink only purified, properly treated, or bottled water, and avoid ice. Eat foods that have been well cooked and are still hot. Avoid raw fruits and vegetables that you do not cook or peel yourself, especially lettuce. Also, avoid foods and beverages from street vendors, seeing that it is difficult for food to be kept clean on the street.

Second, get vaccinated. If you are traveling to a place where typhoid fever exists, you should be vaccinated. You need to complete your vaccination at least 1 week before you travel so that the vaccine has time to take effect. As soon as your travel plans are set, contact WTA partner, Passport Health for information about the typhoid vaccines available.

Signs and Symptoms of Typhoid Fever

People with typhoid fever usually sustain a fever as high as 103° to 104° F. They may also feel weak, have stomach pains, headache, or a loss of appetite. In some cases, patients exhibit a rash of flat, rose-colored spots. The only way to diagnose typhoid fever is to test blood or stool samples for the presence of S. typhi. If you think you have typhoid, see a doctor immediately. If you are traveling in a foreign country, you may call the U.S. consulate for a listing of recommended doctors in your area. You will probably be given an antibiotic to treat the disease. Those who receive antibiotics usually begin to feel better within two to three days. However, those who do not get treated may continue to have a fever for weeks or months. As many as 20% may die from complications of the infection.

Typhoid fever’s danger doesn’t end when the symptoms do. Even if you recover, you may still be carrying S. typhi. If you are, the illness can return, or you could pass the disease on to other people. In fact, if your work includes food handling or the care of children, you may be legally barred from returning to work until it has been determined that you no longer carry any typhoid bacteria.

Additional information about typhoid fever and its vaccines can be obtained by contacting Passport Health. For a listing of Passport Health locations, click here, or call Passport Health directly at 888-499-7277.