Public Health England
National Infections Service
www.gov.uk/phe
PHE gateway number: 2017-066
Dear xxxx
The Health Protection Unit/Environmental Health Department has been told that you have
recently travelled to an area where typhoid is very common. There is a fact sheet with this
letter which has more information about the illness and advice on how you can protect
yourself.
Typhoid infection usually causes a high fever for several days, with headaches, general
pains, stomach upset, constipation or diarrhoea. If you have developed or develop these
symptoms in the next four weeks, please get medical attention immediately and show this
letter to your doctor.
A good way to prevent illnesses such as typhoid is to wash your hands carefully before
preparing and eating food or drinks and after using the toilet. People who are ill or who take
care of others who are ill (such as helping with toileting or changing nappies) should be very
careful with hand hygiene. Young children may need an adult to help them wash their hands.
<For risk group co-travellers only:>
We therefore recommend that you have one stool sample tested for the illness. An
Environmental Health Officer will contact you to arrange for the sample to be taken and tell
you how to get the results.>
If you have any questions, please contact the Health Protection Unit/Environmental health
Department.
Sincerely,
Typhoid and Paratyphoid Fact Sheet
What are typhoid and paratyphoid?
Typhoid and paratyphoid are preventable illnesses caused by salmonella bacteria. They are found
across the world but are more common in countries where sanitary facilities are less developed. In
the UK, most people who have caught typhoid and paratyphoid had recently travelled overseas.
What are the symptoms?
People usually have a high fever with general aches and pains and stomach upset or constipation
(difficulty passing stools (faeces or ‘poo’)). Later they may feel sick, lose their appetite or have
diarrhoea (loose watery stools).
How is it spread?
It is spread through eating food or drinks that contain the bacteria. The food or drink can look clean
but still cause illness. Food or drink can become infected after a person who has been ill handles it,
or when sewage enters drinking water. Sewage can also infect shellfish in the water, and eating
infected shellfish can cause the illness.
How can I protect myself and others?
 Ensure that you wash your hands carefully, using soap, hot water and clean towels. This is most
important after going to the toilet and before preparing a meal, or a drink, or eating.
 Young children may need an adult to help them wash their hands.
 If you have typhoid or paratyphoid, you should avoid cooking food for others while you are on
treatment. If you do have to cook it is important that you wash your hands carefully before
preparing a meal, or a drink, or eating.
 If you plan to travel abroad, ask your GP whether you need typhoid vaccination. It is free. There is
no vaccine for paratyphoid. Hand washing is especially important when travelling.
Do I need to stay off work or school if I have been ill?
The risk of spreading the illness depends on what you do. People who handle food at work, work in
health care, young children, and some others may have a higher risk of spreading the illness. These
people may have to stay off work for longer and provide stool (faeces or ‘poo’) samples to make sure
it is safe for them to return. Your Environmental Health Officer will explain what you should do based
on your personal circumstances.
Why do some people have to submit stool samples?
A doctor may ask you for a stool sample to test for the illness. People who have recently recovered
from the illness or may have been ill with it in the past may also be tested in the same way to see if
they are fully recovered. The Environmental Health Officer will let you know if you need to provide a
stool sample.
Where can I get more information?
You can find information about typhoid and paratyphoid on www.phe.gov.uk or www.nhs.uk. There is
more information about protecting yourself against illness when travelling abroad on
http://travelhealthpro.org.uk. If you have concerns about your health call your GP or NHS 111 on
111.
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