Typhoid and paratyphoid fever are caused by the bacteria Salmonella typhi and Salmonella paratyphi A, B & C.

Affected persons may not have any symptoms. Symptoms of typhoid fever and paratyphoid fever are similar but paratyphoid fever is usually a milder illness. Onset of the illness is usually gradual, with fever, tiredness, chills, headache, and generalised muscle and joint aches. Diarrhoea occurs infrequently. Vomiting may occur but is usually not severe. Complications include bleeding and perforation of the gut. Serious illness may cause death.

Typhoid and paratyphoid fever are transmitted by consuming contaminated water and food, in particular contaminated shellfish, raw fruits and vegetables, and raw milk.

Usually 7 - 21 days.

Infected persons should be hospitalized and isolated for treatment. Infected persons should observe personal hygiene to avoid infecting other persons. The illness can be effectively treated by antibiotics. Fluid replacement and adequate rest are important. Majority of infected persons can fully recover after treatment. About 2 to 5% of patients will become carrier of the bacteria and they may require long-term follow-up.

1. Keep the premises and kitchen utensils clean. Dispose rubbish properly.

2. Keep hands clean and fingernails trimmed.

3. Wash hands properly with soap and water before eating or handling food, and after toilet or changing diapers.

4. Drinking water should be from the mains and preferably boiled.

5. Purchase fresh food from reliable sources. Do not patronize illegal hawkers.

6. Avoid high-risk food like shellfish, raw food or semi-cooked food.

7. Wear clean washable aprons and caps during food preparation.

8. Clean and wash food thoroughly. Scrub and rinse shellfish in clean water. Immerse them in clean water for sometime to allow self-purification. Remove the viscera if appropriate.

9. Store perishable food in refrigerator, well covered.

10. Handle and store raw and cooked food especially seafood separately (upper compartment of the refrigerator for cooked food and lower compartment for raw food) to avoid cross contamination.

11. Clean and defrost refrigerator regularly and keep the temperature at or below 4^oC.

12. Cook food thoroughly.

13. Do not handle cooked food with bare hands; wear gloves if necessary.

14. Consume food as soon as it is done.

15. If necessary, refrigerate cooked leftover food and consume as soon as possible. Reheat thoroughly before consumption. Discard any addled food items.

16. Exclude typhoid carrier from handling food and from providing care to children.

17. Routine typhoid vaccination is not recommended. It may give a false sense of security.