Typhoid and Paratyphoid Fever
Typhoid and paratyphoid fever are intestinal infections that can move through the bloodstream to other parts of the body. They are caused by specific types of Salmonella bacteria called Salmonella Typhi and Salmonella Paratyphi. The bacteria that cause typhoid and paratyphoid fever are different than the Salmonella bacteria that cause food poisoning.
The bacteria can exist in the feces (poop) or urine of infected people and can spread through contaminated food and water, which people then eat or drink.
Most people in New York City with typhoid and paratyphoid fever were infected while traveling internationally to countries in Asia, Africa, and Latin America, where water and food may have been unsafe.
Symptoms
Symptoms generally appear one to three weeks after exposure. They can range from mild to severe, and include:
- Fever
- Headache
- Diarrhea or constipation
- Fatigue
- Weakness
- Stomach pain
- Vomiting
- Rash of flat, pink spots, usually on the chest or stomach
Typhoid and paratyphoid fever can be deadly, so it is important to talk to a healthcare provider as soon as you notice any symptoms.
Prevention
There is a vaccine that can help prevent typhoid fever. Talk to a healthcare provider about the best options for you, especially if you are traveling internationally to countries where typhoid and paratyphoid fever are common.
Even if you get vaccinated before traveling, it is still important to limit your exposure to raw or uncooked food, as well as untreated water. This could look like:
- Drinking bottled water, or boiling water for drinking
- Only eating food that has been thoroughly cooked
- Only eating fruits and vegetables that have been cooked or peeled
- Avoiding undercooked or raw fish and shellfish
- Avoiding foods or beverages from street vendors and restaurants that do not look clean
Diagnosis and Treatment
Healthcare providers can diagnose typhoid and paratyphoid fever by testing your feces or blood. They usually prescribe antibiotics, which can significantly decrease the risk of severe illness or death, but there are some antibiotic-resistant typhoid and paratyphoid fever bacteria. Your healthcare provider can test to see if the bacteria causing your infection is resistant to any antibiotics and treat accordingly.
In rare cases, the infection may not fully clear with a regular course of antibiotics. In these cases, a healthcare provider might prescribe a longer course of antibiotic treatment.
Returning to Work or School
Since the bacteria are found in feces, people should stay home from work, school, or childcare if they have diarrhea. This includes infants, young children, and people with certain types of disabilities.
For specific groups, healthcare providers work with the Health Department to confirm people are not infectious before returning to their regular activities. This includes food handlers, healthcare workers, and children in group childcare. This process may involve follow-up feces testing to be sure they are not at risk of spreading bacteria to others.