A recent outbreak of typhoid fever in neighbouring Zimbabwe was cause for vigilance but not alarm, Dr Pete Vincent, of Netcare Travel Clinics and Tokai Medicross, said.
“In southern Africa, a spike in typhoid cases at this time of year is not unusual. As there is a lot of cross-border traffic over the festive season, however, it is important that the public should be aware of the symptoms of typhoid fever and the importance of seeking medical attention early in the event of them experiencing fever or flu-like symptoms,” Dr Vincent said.
“In the early stages, typhoid and malaria may present similar symptoms and both of these are potentially life-threatening conditions – particularly if medical help is not sought immediately.”
The National Institute for Communicable Diseases (NICD) advised that anyone presenting with fever or flu-like symptoms, who either live in a malaria area or has visited a malaria transmission area, should first be tested for this mosquito-borne illness.
“This is because malaria can very quickly develop into a life-threatening condition, but with early detection and treatment, it can be effectively managed.”
While typhoid fever is also potentially life-threatening, malaria treatment must commence early in the onset of illness in order to be effective, while the window period for typhoid treatment is slightly longer.
“Malaria is also associated with a higher probability of complications if treatment does not commence very soon once symptoms appear,” Dr Vincent said.
Typhoid is a bacterial illness spread via the faecal-oral route, through contaminated food or water, or close contact with an infected person.
In addition to the flu-like symptoms and fever, other symptoms may include nausea, abdominal pain, weakness, constipation or diarrhoea, loss of appetite and, sometimes, a rash of flat rose-coloured spots on the skin.
“It is possible for a person to carry the Salmonella Typhi bacteria that causes typhoid without falling ill, and for such individuals to transmit the illness to others. People who fall ill with typhoid may also be infectious even when the symptoms subside.”
Tips for prevention of typhoid fever
• Consult a travel doctor if you are planning a visit to a typhoid area and discuss whether having a typhoid vaccine is advisable.
• Drink bottled water, preferably sparkling mineral water, rather than tap water and check that the seal on the bottle lid is intact when you open it, to ensure the contents have not been replaced with ordinary tap water.
• Brush teeth with bottled water.
• Avoid ice, as it may have been made with contaminated water.
• If bottled water is not available, either bring the water to a rolling boil for a few minutes or treat it with a water purification tablet to ensure it is safe.
• Wash hands often and thoroughly with soap and use an alcohol-based hand sanitiser, especially after going to the toilet and before and after handling food.
• Practise good food hygiene, and only eat foods that are freshly prepared and served steaming hot – preferably from a busy restaurant with a high turnover.
• Be careful when eating raw or undercooked foods, including vegetables, salads, meat and seafood. Eat only fruit that can be peeled or cut open such as bananas, oranges, pineapples and pawpaws.
• Be aware that travellers returning from typhoid areas may be infectious, even if they do not fall ill themselves.
• Seek medical attention immediately if you develop a fever or flu-like symptoms.
Tips for prevention of malaria
• Well before travelling to an area where malaria is endemic, visit a travel clinic for advice on malaria prophylaxis.
• Apply a good quality DEET (N,N-diethyl-m-toluamide) mosquito repellent.
• If you are wearing sun protection lotion, apply mosquito repellent after the sunscreen.
• Wear long-sleeved shirts and long pants. Mosquitoes are less likely to bite on areas covered by clothing, particularly if the clothing is loose-fitting.
• Protect yourself with a mosquito net when sleeping. Remember to check that there are no rips in the fabric and ensure that you do not let the fabric rest against your skin, as mosquitoes could bite you through the netting.
• Permethrin insect repellent fabric sprays are very useful to spray on collars, cuffs and the bottoms of long pants, as well as curtains, bedding and mosquito nets.
• Always seek medical attention immediately if you experience fever or flu-like symptoms during or after travel. Malaria incubation may take up to 40 days.