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What are enteric fevers?
Typhoid and paratyphoid fevers, collectively known as enteric fevers, are caused by Salmonella Typhi and Salmonella Paratyphi respectively.
Unlike most other types of Salmonella that usually cause diarrhoeal illness, typhoid and paratyphoid mainly cause bloodstream infections.
How are enteric fevers transmitted?
Enteric fevers can spread in several ways:
By eating food or drinking water that have been contaminated with faeces from:
Those currently sick with typhoid fever or paratyphoid fever symptoms
Recovered individuals who remain carriers of the bacteria
Through intimate sexual contact, particularly among men who have sex with men
What are the symptoms of enteric fevers?
Enteric fevers begin with persistent fever, headache and general discomfort.
Additional symptoms include:
Stomach pain
Constipation or diarrhoea
Cough
Loss of appetite
When compared with typhoid fever, paratyphoid fever typically produces less severe symptoms.
What are the risk factors?
Risk factors include:
Travel to areas where typhoid is common, especially places with poor sanitation and limited access to clean water and food
Close contact with someone who is currently infected or was recently infected with enteric fever
How are enteric fevers treated?
Enteric fevers are treated with antibiotics, along with supportive care like rehydration and other interventions. If diagnosed, you will need to:
Take prescribed antibiotics as directed by your doctor
Stay in the hospital for proper monitoring and care
Attend all follow-up appointments after discharge
How to prevent enteric fevers?
Prevent enteric fevers by:
Getting vaccinated (Only applicable for typhoid fever)
Typhoid vaccination is available in Singapore. If you are travelling to countries where typhoid fever is common, consider getting vaccinated against typhoid. As the vaccine does not offer complete protection, you will still need to practise safe eating and drinking habits to avoid getting sick. Please consult your doctor four to six weeks prior to travelling for a health risk assessment for advice on required or recommended vaccinations.
Note: There is currently no vaccine licensed to prevent paratyphoid fever specifically.
Practising safe food and drink habits
Wash your hands regularly with soap, especially before handling food or eating, and after going to the toilet. If water is not available, use an alcohol-based hand sanitiser that contains at least 60% alcohol.
Drink only bottled or boiled water (1 minute at full boil), or canned drinks. Avoid tap water and ice. Use iodine tablets and portable water filters to purify water if necessary.
Eat food that is fully cooked and served hot. Eat fruits which can be peeled (wash before peeling). Avoid eating raw or undercooked meat and seafood, salads, unpasteurised milk/milk products, food prepared in unhygienic conditions and food purchased from street vendors.