Typhoid – health advice for travellers

What is typhoid?

Typhoid and paratyphoid are preventable diseases caused by salmonella bacteria.
The main early symptoms and signs of typhoid fever are fever, headache, general aches and pains, cough and constipation. Later you can develop diarrhoea, stomach discomfort, lack of appetite and feeling sick.
If left untreated, typhoid can cause serious illness or even death.
It can be prevented simply through a typhoid vaccine, which can be obtained free from your GP before you travel, and good hygiene practice while you are abroad.

Typhoid occurs worldwide, but most cases in the UK are in travellers returning from Pakistan, Bangladesh or India and parts of Africa.
Each year in the UK there are about 500 cases in people recently returning from these countries, and almost half of these cases are in London.

In the UK, most people who have caught typhoid and paratyphoid fever had recently travelled to Pakistan, Bangladesh or India.
Most cases are in people of Pakistani, Bangladeshi or Indian descent who have visited friends and relatives.
Even if you have travelled to India, Pakistan or Bangladesh before, you could still catch typhoid if you have not had the vaccine in the last three years.

Typhoid and related paratyphoid illness can be caught by consuming food or drink that has been contaminated with the typhoid bacteria.
Even though the food or drink may look clean, it can contain the typhoid bacteria.
Typhoid is carried in faeces (poo). Food or drink can become contaminated with typhoid when someone with dirty hands touches it, or a fly lands on it.
Water can be contaminated by sewage when there are inadequate sanitation controls in place.
Shellfish can be contaminated with typhoid if harvested from contaminated water.

See your GP at least two weeks before you travel to find out if you need a vaccine for typhoid.
Even if you were born and brought up in Pakistan, Bangladesh or India, or if you have travelled there before, you may still need a typhoid vaccination before you travel. The vaccine protects you for about three years.
There is no vaccine against paratyphoid infection so be careful what you eat and drink. Remember: BOIL IT, COOK IT, PEEL IT OR FORGET IT!
Only eat food that is freshly prepared, cooked and served piping hot, or fruit that you have peeled yourself, such as banana and mango.
Only drink bottled or cooled boiled water, or pasteurised milk. When drinking bottled water ensure the seal is unbroken or choose sparkling water to ensure the bottle has not been refilled.
Wash your hands frequently using soap and water.
Wash your hands before preparing food, eating or drinking, and after using the toilet.
Use bottled or boiled water to brush your teeth. Do not use tap water.

Uncooked food such as salads.
Raw or uncooked shellfish.
Buffets (if you have to eat at a buffet, choose steaming hot dishes).
Unpasteurised milk and cheese.
Ice-cubes (to keep drinks cold put the container or glass on ice, do not put ice in your drinks).
Tap water.
Ice-cream products.
Cold desserts in restaurants.
Leftovers.

Yes. Typhoid can be treated with antibiotics provided by your GP. If typhoid goes untreated it can spread to other family members and contacts in the UK.
If you feel unwell with the symptoms and signs of typhoid fever, either while you are abroad or when you are back in the UK, see a doctor or go to your nearest hospital A&E department.

You are at risk of catching typhoid when visiting friends and family abroad.
Even if you were born or have lived in Pakistan, Bangladesh or India you are still at risk of getting typhoid when you visit these countries.
See your GP or a travel clinic to get a typhoid vaccine before you travel.
Be careful with your hand and food hygiene while abroad – wash your hands with soap and water or alcohol gel before eating and after going to the toilet.
Typhoid can be treated with antibiotics provided by your GP.
If typhoid goes untreated it can spread to other family members and contacts in the UK.
If you feel unwell with the symptoms and signs of typhoid fever, either while you are abroad or when you are back in the UK, see a doctor or go to your nearest hospital A&E department.

This factsheet can also be downloaded as a pdf file:

Last reviewed: 12 December 2011