Preventing Typhoid and Paratyphoid Fever When You Travel

Typhoid fever and paratyphoid fever are common in many countries with poor sanitation and unsafe water and food, including:

• South Asia, especially Pakistan, India and Bangladesh;
• East Asia;
• Africa;
• Latin America.

Two steps help keep travelers safe: get vaccinated before the trip, and eat and drink safely during it.

Drug-resistant typhoid in Pakistan

Every traveler to Pakistan is at risk of extensively drug-resistant (XDR) typhoid fever, which does not respond to most of the antibiotics used to treat the disease. Travelers to Pakistan and neighboring countries should be vaccinated and follow safe eating and drinking habits.

Vaccination

Check whether you need a typhoid vaccine on CDC's travel pages, and see a doctor or travel clinic at least 4 weeks before you leave. Two vaccines are available in the United States:

Protection fades over time; if you were vaccinated before, ask your doctor whether you need a booster.

Safe eating and drinking

These habits matter even if you're vaccinated, because typhoid vaccines aren't 100% effective and no vaccine protects against paratyphoid fever. They also help prevent travelers' diarrhea, cholera and hepatitis A.

Wash your hands thoroughly with soap and water, especially after using the bathroom and before preparing food or eating. If you can't, use hand sanitizer with at least 60% alcohol.

Boil it, cook it, peel it, or forget it:

• Drink unopened, factory-sealed bottled water, or water boiled for at least 1 minute.
• Skip ice, popsicles and flavored ices unless made from sealed bottled water or water boiled for 1 minute.
• Eat only well-cooked food that is still hot and steaming.
• Avoid raw fruits and vegetables you can't peel — lettuce and other greens can stay contaminated even after washing.
• Avoid street-vendor food and drinks unless they're served steaming hot.
• Drink pasteurized milk from a factory-sealed bottle.

Don't wait

If you have a fever and feel very ill, see a doctor and say where and when you traveled. CDC's travelers' health pages can help you find health care abroad.

Sources

• Centers for Disease Control and Prevention: "Preventing Typhoid Fever and Paratyphoid Fever."