Typhoid and paratyphoid fever

At a glance

Typhoid fever: Vaccine preventable – check who’s eligible
Paratyphoid fever: No vaccine available – read more about prevention
Nationally notifiable disease.

About typhoid and paratyphoid

Typhoid and paratyphoid fever are illnesses caused by 2 different strains of Salmonella enterica bacteria. These diseases are often grouped together and called ‘enteric fever’.

Typhoid fever is caused by serotype Typhi.
Paratyphoid fever is caused by serotype Paratyphi.

These bacteria spread to people through contaminated food or water.

Typhoid and paratyphoid fever are different to salmonellosis.

Why it matters to public health

Typhoid and paratyphoid fever are rare in Australia. Most people diagnosed are returning travellers from countries with poor access to sanitation and safe drinking water.

Typhoid and paratyphoid fever are common in parts of:

Asia
Africa
Central and South America
the Middle East
the Pacific Islands.

People with typhoid and paratyphoid fever usually recover after treatment with antibiotics. Before antibiotics were widely available, more than 1 in 10 people with typhoid fever died.

Some strains of the bacteria are becoming resistant to antibiotics. This means that infections with these strains are harder to treat. Detecting these infections is critical to prevent further spread of resistant strains.

If left untreated, typhoid fever can last for around a month.

Because of this, we:

monitor and report on typhoid and paratyphoid fever in Australia
support the surveillance of antimicrobial use and resistance
plan for how to manage major outbreaks.

Symptoms

If you’re looking for advice about your own health or treatment options, see healthdirect or speak with a qualified healthcare professional. Our role is to provide public health advice – information and guidance that helps prevent disease, protect communities and improve wellbeing at a population level.

People with symptoms need immediate medical help.

Typhoid and paratyphoid fever cause similar symptoms, but typhoid fever is often more severe. Some people may have no symptoms.

Early symptoms may include:

fever
headache
feeling generally unwell.

This can progress to:

Complications, especially if inadequately treated, can include:

infection of the bone marrow or bloodstream
bleeding or tears in the digestive system
inflammation of the heart
persistent infection of the gall bladder requiring surgical removal.

healthdirect’s symptom checker can help you decide whether to see a health professional.

Check your symptoms

Onset of symptoms

Typhoid fever

Symptoms of typhoid fever usually start between 8 and 14 days after getting infected, but this can range from 3 days to several months.

Paratyphoid fever

Symptoms of paratyphoid fever usually start between 1 and 10 days after getting infected.

How it spreads

Typhoid and paratyphoid fever usually spread when people consume food or water contaminated with stool or, less often, urine from an infected person.

After infection, some people can become chronic carriers – even if they never had symptoms.

A carrier is a healthy person who still has the bacteria in their stool or urine and can spread it to others. This happens more often with typhoid fever infections.

People can get typhoid and paratyphoid fever more than once.

Infectious period

People with typhoid and paratyphoid fever are infectious for as long as the bacteria stays in their stool, even if they don’t have symptoms.

For people who aren’t treated, this can be weeks or months.

Chronic carriers can continue to spread the bacteria to others for years.

Prevention

Vaccination

There is no vaccine for paratyphoid fever.

A typhoid fever vaccine is available in Australia, and is recommended for:

military personnel
laboratory workers who routinely work with Salmonella Typhi
anyone aged 2 years or over who is travelling to regions where typhoid fever is common.

Other prevention steps

People who travel to areas where typhoid and paratyphoid fever are common should:

wash hands often, especially after using the toilet and before preparing or eating food
avoid raw or undercooked foods, including fruit and vegetables (unless they peel it themselves)
avoid drinking untreated water, including ice in cold drinks – drink only bottled or boiled water
avoid food from street stalls.

Read more ways to prevent typhoid and paratyphoid fever and to travel safely.

Until advised by their healthcare professional or public health unit that it is safe to resume normal activities, people with typhoid or paratyphoid fever should:

stay at home from work, school and early childhood education and care centres
not prepare or handle food for others
wash hands often, especially after using the toilet and before eating
not swim in public aquatic facilities.

Priority groups and settings

People at greater risk of severe disease

Typhoid and paratyphoid fever pose a greater risk of severe illness for:

people who are immunocompromised
people with cardiovascular disease
children aged under 5 years.

People with typhoid fever are more likely to become severely unwell than people with paratyphoid fever.

People at greater risk of exposure

People are at greater risk of exposure if they:

travel to countries where typhoid and paratyphoid fever are common, including people visiting family and friends
are in close contact with someone with typhoid or paratyphoid fever
consume food or drink prepared by someone with typhoid or paratyphoid fever.

Diagnosis and treatment

Typhoid and paratyphoid fever can be diagnosed with a stool test or, if necessary, a blood test.

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Typhoid and paratyphoid fever are treated with antibiotics. People who develop severe illness may be treated in hospital.

Read more about how to manage or treat typhoid and paratyphoid fever.

Surveillance and reporting

Typhoid and paratyphoid fever are nationally notifiable diseases – these are diseases that present a risk to public health.

Health authorities in each state and territory report new laboratory confirmed cases to us daily through the National Notifiable Diseases Surveillance System.

We also collect and analyse data on typhoid and paratyphoid fever cases through OzFoodNet network. This includes details about people’s overseas travel and food consumption.

These are part of our routine surveillance activities, which help us monitor case numbers around the country and understand disease patterns.

We analyse the data and report on case numbers and other data through our data visualisation tool, where you can filter and search the latest information.

Outbreaks

Outbreaks of typhoid and paratyphoid fever are rare in Australia. Most people who are diagnosed in Australia are recent travellers from countries where typhoid and paratyphoid fever are common.

In responding to a typhoid or paratyphoid fever outbreak, public health agencies:

identify the source of infection
quickly address any potential contamination
advise infected people about how long to stay away from work, school or early childhood education and care centres
identify and provide advice to other people who might have been exposed
provide information to people about the disease and the importance of safe food handling, preparation and storage and hand hygiene.

Read more about how the Australian Government defines and plans for outbreaks.

Support

For information about typhoid and paratyphoid fever in each state or territory, see:

For travel advice, see: