Paratyphoid fever

You are most likely to get paratyphoid from eating food or drinking water that has been contaminated with poo (faeces) from someone who has the illness (even if they do not have symptoms).

Paratyphoid is more common in countries where sanitation and clean water are lacking, including some countries in Asia (particularly India, Pakistan and Bangladesh), Africa, and Central and South America. You can become infected by swallowing or having contact with contaminated:

• water and shellfish with sewage in them
• raw fish, fruit and vegetables
• turtles and tropical fish kept at home.

The symptoms usually start 7 to 21 days after you have caught it. Common symptoms include:

• a high temperature
• feeling cold and shivery (chills)
• stomach pain
• tiredness
• headaches
• loss of appetite
• hard poo (constipation) in adults
• a rash of small pink spots.

Paratyphoid fever can cause similar symptoms to typhoid fever. However, it is usually milder, over more quickly, and has fewer complications. Serious cases of paratyphoid fever may require hospitalisation and result in a longer illness.

If you think you have typhoid visit your healthcare provider. You may be asked to send a sample of your poo to a laboratory for testing.

Testing is free and your healthcare provider will let you know what you need to do.

The role of public health

Paratyphoid is a notifiable disease. This means healthcare providers or laboratories will inform public health when someone has it. This way we can:

• monitor how many people are sick
• contact people you have been in contact with and arrange for testing of their poo, to check if they have also been infected
• give advice on how to reduce its spread.

If you have paratyphoid you will be treated with antibiotics to clear the infection from your body. More serious cases may need hospital treatment.

Paratyphoid is highly infectious. Wash and dry your hands carefully with soap and water after using the toilet and avoid preparing or serving food for other people. You should not return to work until 48 hours with no symptoms. However, if you work or attend a high risk place, you will also need to have 2 negative stool tests before you can return.

If you were infected overseas, people who travelled with you may also need to be tested. If you were infected in New Zealand, people you live with and/or have close contact with will also need to be tested for infection.

High-risk places

There are some high-risk places where paratyphoid can spread very easily, such as:

• workplaces that handle food or drinks
• health and aged care facilities
• schools and early childhood centres.

People with paratyphoid fever can only return to high-risk places if they have had:

• no symptoms for at least 48 hours
• 2 follow-up tests after being symptom free and completion of antibiotics, at least 48 hours apart.

These tests will check you are no longer infectious and reduces the risk of you passing paratyphoid to others.

Good hygiene

Be careful with the food you eat and what you drink.

Wash your hands often and thoroughly.

Be careful around pēpi and tamariki, even if they are in nappies.

Preventing the spread of food and water borne diseases (internal link)

Travel advice to prevent paratyphoid

If you are travelling to countries where paratyphoid is more common you can reduce your risk of infection.

• Avoid unsafe drinking water, including ice and drinks mixed with water.
• Only drink bottled water and boiled water.
• Avoid food from street stalls.
• Make sure hot food is well cooked and eat it while it is hot.
• Avoid uncooked and raw food, including fruit and vegetables, unless you are able to wash, prepare and peel them yourself.
• Avoid raw (unpasteurised) milk or dairy products.