Cookies on the Bupa website

We use cookies to help us understand ease of use and relevance of content. This ensures that we can give you the best experience on our website. If you continue, we'll assume that you are happy to receive cookies for this purpose. Find out more about cookies




Typhoid and paratyphoid (also known as enteric fever) are infections caused by bacteria. They’re very rare in the UK – only about 300 to 350 people get one of these infections each year. They’re much more common in other parts of the world, particularly in less developed countries with poor sanitation. Most people in the UK catch it when they visit India, Pakistan or Bangladesh.

A woman in an airport waiting for her flight


  • Symptoms Symptoms of typhoid and paratyphoid

    You’ll usually start to get the symptoms of typhoid about one to three weeks after you get the infection. The first symptoms of typhoid can include:

    • a fever that gets steadily worse until your temperature sits at 39°C or higher
    • a headache
    • feeling weak and tired

    Other symptoms can include:

    • chills
    • feeling sick or vomiting
    • tummy pain
    • diarrhoea or constipation 
    • a rash, or small pink spots on your chest or tummy
    • a cough
    • sore muscles

    You might just have mild symptoms, and some people don’t get any symptoms at all.

    Symptoms of paratyphoid are similar to typhoid but they aren’t normally as severe, and you might develop the fever later, after the other symptoms.

    If you’ve just returned from abroad and have these symptoms, contact your GP; or if you’re really unwell, your local accident and emergency (A&E) department. Remember to tell them where you have been travelling.

  • Diagnosis Diagnosis of typhoid and paratyphoid

    If you visit your GP, they’ll ask about your symptoms and examine you. They’ll also want to know if you’ve recently travelled abroad, particularly to countries where the infection is.

    If your GP thinks you may have typhoid, they’ll arrange for you to see a specialist to have some tests. You may need to give a sample of your poo (faeces) – these will be sent to a laboratory to be tested to check if you have typhoid or paratyphoid. You might also need to provide blood and urine samples to be tested.  

    If you are very unwell, your GP might arrange for you to be admitted to hospital.

    Typhoid is a notifiable disease. This means that if your doctor thinks you have typhoid or paratyphoid, by law, they have to report it.

    If somebody you travelled abroad with, live with or have close contact with becomes ill with typhoid or paratyphoid, you might have caught it too. Even if you don’t feel unwell, your GP or a doctor who specialises in public health will usually take a sample of your faeces to test.

  • Treatment Treatment of typhoid and paratyphoid

    Typhoid and paratyphoid can be treated with antibiotics. You usually take these as tablets but if you’re really unwell, you might have them through a drip (intravenously).

    It’s important to take your antibiotics as your doctor prescribes. Take the full course of tablets – don't stop taking them early, even if you get better. For more advice about how to take them, see our information on Antibiotics.

    Sometimes, typhoid and paratyphoid bacteria are resistant to certain antibiotics. This means the medicine won’t cure your infection. Your doctor will choose which antibiotics to give you carefully. If they don’t work, you may need to try a different type of antibiotic.

    After your treatment

    After you’ve finished your treatment, your doctor might need to take samples of your poo (faeces) again and test them. This is to make sure no bacteria are left in your body. This may be particularly necessary if you handle food in your job, or are a carer. If you still have an infection, you may need to take more antibiotics.

  • Causes Causes of typhoid and paratyphoid

    Typhoid is caused by a bacteria called Salmonella enterica Typhi (S. typhi), while paratyphoid is caused by Salmonella enterica Paratyphi (S. paratyphi).

    You can catch them if you eat food or drink water that contains bacteria from the poo (faeces) of an infected person. The bacteria can be spread to your food if an infected person touches it, or a fly lands on the poo then on food. Or it can be spread if water is contaminated by sewage, if the area you’re in has poor sanitation.

  • Complications Complications of typhoid and paratyphoid

    If you don’t get any treatment, typhoid (and occasionally paratyphoid) can cause serious problems, and it can even be fatal. Complications include:

    • internal bleeding in your digestive system – this can lead to a hole (perforation) in your bowel
    • kidney failure
    • inflammation in your heart muscle
    • feeling confused and effects on your mental functioning
    • pneumonia
  • Prevention Preventing typhoid and paratyphoid

    There are ways to lower your risk of catching typhoid or paratyphoid when you travel to an area where it’s common. Here are some tips.

    • Wash your hands regularly with soap and water before you eat, and after you go to the toilet. 
    • Only drink bottled water (make sure the seal is intact) or tap water that’s been boiled or chlorinated. Remember to also use this type of water to brush your teeth.
    • Don’t have ice cubes in drinks, or eat ice cream and cold desserts.
    • Eat food that’s freshly prepared, cooked thoroughly and hot – you might want to skip buffets.
    • Don't eat any raw vegetables, such as salads, if there’s any chance they have been washed in unclean water.
    • Only eat fruit that you peel yourself.


    There’s a vaccine for typhoid, which you can have before you go to an area where typhoid is found. It’s a good idea to have it if there isn’t clean water or good sanitation where you’re going. Make an appointment to have the vaccine at least a couple of weeks before you go.

    The vaccine will reduce your risk of catching typhoid but won't completely protect you from the disease. And it doesn’t work against paratyphoid. So, it's very important to follow the prevention tips above, even if you've had the vaccine.

    You can have a typhoid vaccine as an injection or capsule.

    • Capsule. Adults and children over six can take the typhoid vaccine as capsules. You’ll need to take three of them on alternate days. You’ll then be protected for one to three years, depending on how much exposure you have to the bacteria. After that, you can have a booster if you’ll be returning to areas with typhoid. Let your GP or travel clinic know if you’re taking medicines, particularly antimalarial medicines, as they might affect how well the vaccine works. Tell them when you make your appointment.
    • Injection. Adults and children over two years can have the vaccine. If you have the injection, it will protect you from typhoid for three years. After that, you can have a booster if needed, which is a second vaccine. There’s a combined typhoid and hepatitis A vaccine injection for adults and children over 15.

    If you’re planning on travelling outside of the UK, take a look at our travel vaccinations page for more information.

  • Video: Bacterial vaccines [Video] How bacterial vaccines work

  • Special considerations How to prevent passing the infection to others?

    When you’re ill with typhoid or paratyphoid (and for some time after you recover), you could pass the infection on to others. Your doctor will explain good hygiene measures to reduce the chance of this. For example, it’s important to wash your hands often using soap and water. Do this each time before you prepare food, eat or drink, and after you go to the toilet. Older people and children are more at risk of getting seriously unwell if they get typhoid. Be especially careful not to pass on the infection to them.

    If you’re a carer or work in the food industry, you’ll need to take some time off or avoid some tasks while you have the infection. For more information on how to avoid passing on the infection when preparing food, see our information on Food hygiene. If your child has typhoid or paratyphoid, they might need to stay out of nursery or school while they’re infectious.

    A doctor who specialises in public health may contact you to ask you some more questions to identify how you caught typhoid. They might ask to test other members of your family or household to ensure they aren’t carrying the infection.

    Typhoid carriers

    Occasionally, people carry the bacteria in their bodies for months or even years after they feel better. These people are known as typhoid or paratyphoid ‘carriers’. Up to five in 100 people with typhoid become long-term (more than one year) carriers. If you’re a carrier, your doctor will give you antibiotics to treat the infection. They’ll then test your poo (faeces) after a week to check that the infection has cleared. If it hasn’t, you may need to have more treatment. If you care for others or prepare food, you might need to take time off until it clears. Ask your GP or public health specialist doctor for advice on when it’s safe for you to go back to work. Your GP will need to check with a public health specialist doctor before they can give you an answer.

  • FAQ: Typhoid and pregnancy Should I take extra precautions if I’m pregnant?

    If you're pregnant, it's really important to take steps to lower your risk of catching typhoid or paratyphoid. This is because the treatment for typhoid is antibiotics, and, if you’re pregnant, there are fewer types of these that you can safely take.

    If you're travelling to an area with typhoid, it’s really important to follow our advice about lowering your risk – see Preventing typhoid and paratyphoid above. It’s also a good idea to follow general advice about what foods you shouldn’t eat while you’re pregnant. For more information, see Healthy eating during pregnancy.

    Although there’s a typhoid vaccine, you can only have this if the benefits of the vaccine outweigh the risks to you and your baby. This is because doctors aren’t sure if the vaccine may affect your baby. If you’re considering having the vaccine, talk your options through with your doctor.

    How many weeks before travelling should I have a typhoid vaccination?


    If you’re travelling to an area with typhoid, a lack of clean drinking water and poor sanitation, visit your GP to have a vaccination at least two weeks before you travel.


    The typhoid vaccine can take two weeks to work. So, it’s important you have it early enough before your trip abroad to be protected as much as possible.

    Remember, although the vaccine reduces your risk of catching typhoid, some risk remains. Follow advice about drinking bottled water, avoiding certain foods and washing your hands.

    Will the typhoid vaccine make me ill?


    You may have mild side-effects after the typhoid vaccination.


    Side-effects are the unwanted but mostly temporary effects you may get after having a vaccination. If you have the vaccine by injection, side-effects can include:

    • pain, swelling, hardness and redness at the injection site
    • stomach problems, such as abdominal (tummy) pain, nausea and diarrhoea 
    • fever
    • headache

    Very rarely, it can cause anaphylaxis, which is a serious allergic reaction. If you have the vaccine by mouth, side-effects can include:

    • abdominal pain and cramps
    • feeling sick or vomiting
    • diarrhoea

    Speak to your GP for more information and advice.

  • FAQ: Timing of vaccine When should I have a typhoid vaccine?

    If you’re travelling to an area with typhoid, make plans to have vaccination at least a couple of weeks before you travel. The typhoid vaccine injection can take this long to work; it’s important you have it early enough so you’re protected. The oral capsules take about 10 days to give you protection against typhoid.

    Remember that although the vaccine reduces your risk of catching typhoid, there’s still some risk that you’ll get it. Follow advice about preventing typhoid and paratyphoid above.

  • FAQ: Vaccine side-effects Will the typhoid vaccine make me ill?

    You might get some mild side-effects after you have the typhoid vaccine. Side-effects of the capsules can include:

    • tummy pain and cramps
    • feeling sick or vomiting
    • diarrhoea

    Side-effects of the injection include:

    • pain, swelling, hardness and redness where you were injected
    • stomach problems, such as tummy pain, feeling sick and diarrhoea
    • a fever
    • a headache

    Very rarely, it can cause anaphylaxis, which is a serious allergic reaction.

  • Other helpful websites Other helpful websites

    Further information


    • Typhoid infection. BMJ Best Practice., last updated 18 October 2016
    • Enteric fever (typhoid and paratyphoid) England, Wales and Northern Ireland: 2014. Public Health England., published December 2015
    • Public health operational guidelines for typhoid and paratyphoid (enteric fever). Typhoid and Paratyphoid Reference Group., published February 2012
    • Typhoid: the green book, chapter 33. Gov.UK., last updated 28 August 2015
    • Typhoid and paratyphoid fever. PatientPlus., last checked 25 February 2015
    • Infection reports – volume 10 number 6. Public Health England., published 6 February 2016
    • Typhoid – health advice for travellers. Public Health England., published 2014
    • Contacts: PHE health protection teams. Public Health England., last updated 5 October 2016
    • Antibiotic awareness key messages. Public Health England., published October 2016
    • Typhoid fever. Medscape., updated 16 February 2016
    • Typhoid fever. The MSD Manuals., last full review/revision May 2016
    • International travel. NICE British National Formulary., reviewed February 2017
    • Food and water safety. Centers for Disease Control and Prevention., last updated 20 October 2015
    • Typhoid vaccine. NICE British National Formulary., reviewed February 2017
    • Typhoid vaccines. NICE British National Formulary., reviewed February 2017
    • Prescribing in pregnancy. NICE British National Formulary., reviewed February 2017
    • Active immunity. NICE British National Formulary., reviewed February 2017

  • Has our information helped you? Tell us what you think about this page

    We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.

    Let us know what you think using our short feedback form
  • Related information Related information

  • Author information Author information

    Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, April 2017
    Expert reviewed by Dr Martin Wiselka, Consultant in Infectious Disease
    Next review due March 2020

About our health information

At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.

  • Information Standard

    We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.

    Information standard logo
  • HONcode

    This site complies with the HONcode standard for trustworthy health information:
    verify here.

    This website is certified by Health On the Net Foundation. Click to verify.

What our readers say about us

But don't just take our word for it; here's some feedback from our readers.

Simple and easy to use website - not alarming, just helpful.

It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.

Good information, easy to find, trustworthy.

Meet the team

Nick Ridgman

Nick Ridgman
Head of Health Content

  • Dylan Merkett – Lead Editor
  • Graham Pembrey - Lead Editor
  • Laura Blanks – Specialist Editor, Quality
  • Michelle Harrison – Specialist Editor, Insights
  • Natalie Heaton – Specialist Editor, User Experience
  • Fay Jeffery – Web Editor
  • Marcella McEvoy – Specialist Editor, Content Portfolio
  • Alice Rossiter – Specialist Editor (on Maternity Leave)

Our core principles

All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.

An image showing or editorial principals

                  Click to open full-size image

The ‘3Rs’ encompass everything we believe good health information should be. From tweets to in-depth reports, videos to quizzes, every piece of content we produce has these as its foundation.


In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.


We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.


We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.

Our accreditation

Here are just a few of the ways in which the quality of our information has been recognised.

  • The Information Standard certification scheme

    You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.

    It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.

    Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.

  • British Medical Association (BMA) patient information awards

    We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.

Contact us

If you have any feedback on our health information, we would love to hear from you. Please contact us via email: Or you can write to us:

Health Content Team
Battle Bridge House
300 Grays Inn Road

Find out more Close

Legal disclaimer

This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition.

The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.

For more details on how we produce our content and its sources, visit the 'About our health information' section.

ˆ We may record or monitor our calls.