What is Typhoid fever?
Typhoid fever is a potentially fatal systemic infection caused by Salmonella typhi bacteria. It is one of the enteric fevers (along with paratyphoid A, B & C) and is typically acquired through consuming food or water contaminated with the faeces or urine of an infected person or chronic human carrier (humans are the only reservoirs of infection).
What are the symptoms?
The incubation period can vary depending on the quantity of bacteria consumed, ranging from 1 – 3 weeks, but it may also be longer. Early symptoms can be non-specific and resemble other travel-related infections, such as dengue fever or malaria: fever, malaise, anorexia, headache, rash, abdominal pain and constipation or diarrhoea. Some people have only a mild illness, but untreated infections can deteriorate resulting in intestinal haemorrhage, bowel perforation and death. Others again may be asymptomatic, although the individual can still carry the typhoid organism long-term and is capable of transmitting the infection. Some 5% of people suffering typhoid fever become chronic carriers.
Where is it found?
Once universally prevalent, improved sanitation and higher standards of hygiene has meant that typhoid fever is now mostly a public health concern in resource-poor regions. Still, the WHO reports that between 11 and 20 million typhoid infections occur every year, resulting in more than 120,000 deaths.
Risk to travellers
The areas of the world where sanitation is sub-standard are those with the highest risk of infection for travellers, particularly India, Pakistan, and Bangladesh, but also parts of Africa, the Middle East, the Caribbean, and Central and South America. Typhoid immunisation is crucial for anyone travelling to developing countries and is highly advisable for people visiting friends and relatives, travelling to rural areas and for prolonged travel. In addition vaccination is important for those with adventurous eating habits and in people with some medical conditions (such as lowered gastric defences).
How is Typhoid fever treated?
While typhoid continues to be curable and can be treated with appropriate antibiotics, resistance is spreading and there are now extensively drug resistant forms of the bacteria, resistant to several types of antibiotics.
Travelvax urges individuals travelling to developing countries to be vaccinated against typhoid to prevent the transmission of this disease. Our typhoid vaccination process is as follows:
What is Typhoid fever Vaccination?
- Oral live-attenuated vaccine (Vivotif oral)
- Injectable, synthetic (Typhim Vi)
- Injectable, combined with Hepatitis A (Vivaxim)
In some typhoid endemic countries, a new conjugate typhoid vaccine (Typbar-TCV) is now available and is given to adults and children from 6 months of age, offering at least 3 years protection. It is not licensed in Australia as yet.
- One capsule taken one hour before food on alternate days i.e. days 1, 3 and 5 – it should be taken with water and not chewed. The vaccine is licensed for children 6 years of age and older, and adults. It confers protection for three years, a 4-dose schedule given on alternate days (1, 3, 5 & 7) confers five years cover.
NB: As this is a live vaccine, it is not suitable for the following groups and the injectable form should be given: pregnant women and immunocompromised people. The vaccine may be inactivated if taken with some antibiotics and antimalarial medications – check with the prescribing doctor.
Also, if the oral cholera vaccine (Dukoral) is also prescribed, at least 8 hours should lapse between the 2 vaccine doses.
- Typhim Vi – A single dose gives 3 years protection for children aged 2 years and over, and adults.
- Vivaxim – A single dose gives 3 years protection for children aged 16 years and over, and adults. It also provides a single dose of hepatitis A vaccine (Avaxim).
Booster doses for both vaccine types, oral and injectable, do not apply. If at continued risk after 3 years (or 5 years for the 4-dose oral schedule), the vaccine dose is repeated.
Level of protection
- Oral vaccine - approx. 70% up to 1.5 years after vaccination, falling to 50% after 3 years; food and water precautions are important.
- Injectable vaccine offers ~75% protection; food and water precautions are important.
Possible Side Effects
Usually infrequent and mild:
- Oral vaccine:
Abdominal pain, nausea, vomiting, diarrhoea and rash.
- Injectable vaccine:
Fever and headache (9% of recipients)
Redness, soreness, swelling and itching around the injection site.
General malaise, nausea.
As with all vaccines, there is a small risk of allergic reaction.
Where can I get a Typhoid fever vaccination from?
If you require vaccination against Typhoid Fever, head to a Travelvax clinic near you. Staffed by trained professionals who have access to state-of-the-art equipment, we can help keep you safe on your next trip.