To:
<Date>
Dear < >
The <Health Protection Unit/Environmental Health Department> has been told that you are a
close contact of a person with <typhoid/paratyphoid> infection. There is a fact sheet with this
letter which has more information about the illness and advice on how you can protect
yourself.
<Typhoid/paratyphoid> infection usually causes a high fever for several days, with
headaches, general pains, stomach upset or diarrhoea. If you 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/paratyphoid> 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 co-travellers only:>
<The <Health Protection Unit/Environmental Health Department> has also been informed
that you have recently travelled to an area where <typhoid/paratyphoid> is very common.
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.hpa.org.uk or www.nhs.uk.
There is more information about protecting yourself against illness when travelling abroad on
www.nathnac.org. If you have concerns about your health, call your GP or NHS Direct on
0845 46 47.