The National Institute for Communicable Diseases would like to raise awareness amongst returning travellers and their health care providers for typhoid fever following the recent increase in the number of cases reported in Zimbabwe, and the increased risk of importation of cases into South Africa. While an outbreak of typhoid in South Africa is not anticipated, it is important that persons with symptoms suggestive of typhoid receive appropriate and early diagnosis and treatment. Typhoid is endemic in southern Africa, with seasonal increases in January and February.
Typhoid is caused by the bacterium Salmonella Typhi. It is endemic in the southern African region and is spread from person-to-person by faeco-oral contamination, direct contact, or through ingestion of contaminated food or water contaminated with S. typhi.
- Contaminated water sources create larger outbreaks of typhoid, while food contaminated by persons who have typhoid or who are carriers or recovering from typhoid will cause smaller, localised cases usually amongst family or friends.
- Fruit that can be peeled (e.g. bananas, oranges or mangos) or meat that is well cooked is generally safe.
- Typhoid prevention measures include hand washing after toilet use and before preparing food, consumption of safe water, and good sanitation.
Symptoms of typhoid include fever, headache, chills and sweats, abdominal pain, constipation or diarrhoea. Persons with these symptoms should under testing with a blood culture. Typhoid responds well to treatment with antibiotics. The symptoms of typhoid overlap with a number of other infectious diseases important in the region at this time of year, especially malaria. Malaria must be considered first in all persons residing in or with a history of travel to malaria transmission areas who present with fever or a ‘flu- like‘ illness. Since malaria is rapidly progressive but responds well to early treatment, malaria blood tests must be done as a matter of urgency and treatment provided rapidly.
More information on symptoms, diagnosis and treatment of typhoid is available on the NICD website. If persons suspect typhoid, they should consult their local clinic or health care provider