They cause very similar diseases collectively known as enteric fever and mainly affect low income areas of the world where sanitation is poor and clean drinking water is not widely available. The majority of global cases of disease occur in Asia, but the disease continues to be a concern in other areas including Africa and parts of Central and South America.

The majority of travel related infections in the UK occur in those visiting friends and relatives in countries of the Indian subcontinent (Bangladesh, India and Pakistan).

Symptoms of typhoid and paratyphoid include: fever, headache, muscle or joint pains, constipation or diarrhoea and a rash. Complications include intestinal bleeding and perforation (development of a hole in the wall of the bowel). If treated most people will make a full recovery however if untreated death rates can be high. Antibiotic resistant infections are increasingly common; this can complicate and reduce treatment options.

Prevention

The risk of acquiring typhoid or paratyphoid can be reduced by ensuring good personal hygiene and following advice on the prevention of food and water-borne diseases.

Typhoid vaccination

Vaccination is recommended for travellers whose planned activities put them at higher risk of typhoid infection in areas where sanitation and food hygiene are likely to be poor. Vaccinations currently available only protect against typhoid and not paratyphoid infection.

Both oral and injectable vaccines are available. Some vaccinations are combined with hepatitis A.