Typhoid Fever

Typhoid fever is a serious bacterial infection caused by a type of Salmonella bacteria called Salmonella Typhi. Typhoid fever is not common in Canada and is mostly linked with travel to countries that do not have adequate sewage and water treatment. 

Salmonella Typhi is spread from person to person through ingestion of contaminated food or water contaminated with feces (stool) or urine from an infected person who may or may not appear ill. In areas with poor sanitation, untreated sewage gets into the drinking water and food supply. People become ill with typhoid fever when they drink water contaminated with infected stool, or eat raw or undercooked seafood from the contaminated water. People may also become ill with typhoid fever if they eat produce that has been watered or washed with contaminated water.

Salmonella Typhi may also be spread by people who are chronic carriers of the bacteria. These people may not show any symptoms but may spread the infection to others through direct contact with stool or items contaminated with stool.

Symptoms usually appear 8 to 14 days (sometimes in as little as 3 days) after a person is exposed, but the symptoms may not appear for over 60 days after contact with the bacteria. Generally, someone with typhoid fever feels very ill. Symptoms include high fever, headache, abdominal pain with either constipation or diarrhea, lack of appetite, and rash. People with weakened immune systems are more at risk to become ill and have more severe symptoms. Not everyone with typhoid fever will have symptoms, but they are still able to spread the disease as long as the bacteria are in their stool.

Antibiotics are generally recommended by a health care provider. If symptoms are persistent or severe, it is important to seek medical attention.

Anyone with typhoid fever should stay home from work or school until they feel better and no longer have symptoms. Those who prepare or handle food, healthcare workers, childcare workers and those who attend child care must not return to work until advised by Ottawa Public Health.

To prevent coming ill with typhoid fever:

• Get immunized against typhoid fever before travelling to countries where sanitation is poor, or where there is known typhoid fever
• Use sealed bottled water or treated (chemically disinfected or boiled) water instead of tap water for drinking, brushing teeth, preparing foods, making ice and cooking when travelling to countries where the water supply is uncertain
• Do not eat raw shellfish; ensure all shellfish is steamed or boiled for at least 10 minutes before eating
• Avoid eating or drinking unpasteurized (raw) milk or milk products
• Always wash hands well with soap and water for at least 15 seconds before and after preparing food, before eating, after using the toilet, after changing diapers and anytime hands may be dirty
• Avoid contact with feces (stool) during sex
• If you have diarrhea, avoid preparing food or drinks  

Ottawa Public Health (OPH) must be notified by health care providers and laboratories about persons who have or may have paratyphoid fever. OPH provides education to such persons and their close contacts and follows up with their health care providers as needed. OPH will also advise each person and close contacts about return to work and child care.