Causes of Typhoid fever

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Typhoid bacteria are released in the urine and faeces of infected people. If they do not wash their hands properly before handling food, the disease may be spread to anyone that eats the food. It can also be transmitted by flies and other insects and if contaminated sewage gets into drinking water.

The typhoid bacterium can survive refrigeration, freezing and drying so it is important to have high standards of food hygiene and personal hygiene. Water supplies are a common source, and even ice can transmit the disease. Shellfish may be contaminated by sewage containing infected faeces and in the past, contaminated tinned meat products have caused epidemics in Britain.

Once a person is infected, the bacteria accumulate and multiply in the gall bladder and then pass into the bowel in enormous numbers. The bacteria then penetrate the lining of the intestine (gut), multiplying and spreading into the bloodstream. From here, the infection can move into the bone marrow, liver and bile ducts and small intestine. The time when most people are infectious is the week before the illness and first week of the illness.

As well as someone with the active disease, typhoid fever can also be caught from a â€˜carrierâ€™. A carrier is someone who carries the bacteria in their system after they have recovered from the disease They do not show symptoms of the disease but can spread it via their faeces. Approximately 5% of people carry the bacteria for a year or more (4). It is vital that a carrier of typhoid should not have an occupation that involves handling food. Treatment is available for carriers of typhoid; the disease can be eradicated with antibiotic treatment for 4-6 weeks (5).