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Typhoid
The Disease
Typhoid fever is an infection caused by Salmonella typhi bacteria. The disease causes fever, headaches, fatigue and constipation (although diarrhoea may also occur). Symptoms may last for 3 weeks or longer. Some patients have only a mild illness, however the disease can occasionally be fatal if not treated. Others may be asymptomatic, although they may carry the Typhoid organism long-term and are capable of transmitting the infection. Some 5% of people suffering Typhoid become chronic carriers.
Typhoid is curable and can be treated with appropriate antibiotics.
Where is it found?
Typhoid is a public health concern in developing countries worldwide. Prevalence is high throughout Asia, Africa and South America.
Risk to travellers
Typhoid is transmitted by food and water that has been contaminated with faecal material from persons who either have the disease or are carriers.
The risk of infection increases for those with one or more of the following risk factors:
- prolonged travel (over 2 weeks).
- travel to rural areas.
- living in conditions with poor sanitation.
- adventurous eating habits.
- some medical conditions, such as lowered gastric defences
Vaccination
Type:
- Oral live-attenuated vaccine (Vivotif oral).
- Injectable, synthetic (Typhim Vi/Typherix).
- Combined with Hepatitis A (Vivaxim)
Standard Schedule:
- Oral (refrigerated):
Three capsules at 0, 3, 5 days confers protection for three years. - Injection:
Single dose gives 3 years protection.
Level of protection:
- Oral vaccine provides about 75% protection: food and water precautions are important.
- Injectable vaccine offers ~84% protection: food and water precautions are important.
Possible side effects:
Usually infrequent and mild:
- Injection:
Fever and headache (9% of recipients)
Redness, soreness, swelling and itching around the injection site.
General malaise. - Oral:
Abdominal pain, nausea, vomiting, diarrhoea and rashes.
As with all vaccines, there is a small risk of allergic reaction.