Typhoid Vaccines
- Feb 2, 2017
- 2 min read
Typhoid fever is a febrile illness that can be severe and occasionally even life threatening. It is caused by Salmonella enteric serotype typhi. Interestingly humans are the only source of bacteria. It is acquired through ingestion of water and food contiminated with feces of someone who is actively infected, or recovering from infection, or someone who is a chronic carrier of the bacteria. Rarely has transmission been documented through sexual contact by males who have sexual contact with males.
There are 22 million cases of typhoid and 200,000 deaths throughout the world every year. In the US every year there is about 300 cases confirmed. Travelers to Asia, Africa, the Caribbean and Central and South America are at risk. The numbers have decreased and pre-travel vaccines for Eastern Europe and the Middle East are no longer recommended in 26 countries in these areas (CDC, 2016).
Travelers visiting friends and relatives are at high risk, and those who stay in at risk areas longer are also at higher risk; however infection can occur while traveling even less than 1 week.
The incubation period is 6-30 days. Onset of symptoms is gradual with increase fever and fatigue. Temperatures start from low grade to as high as 102-104 by 3rd or 4th day. Symptoms also include headaches, malaise, and loss of appetite, abdominal pain, diarrhea, or constipation are also common Sometimes a rash is noticed on a person's trunk. The fever peaks in the afternoon or evening. It can be confused with malaria. Serious complications can occur 2-3 weeks after the start of the illness and can include intestional hemorrhage or perforation which can be life threatening.
There is no perfect test for diagnosing typhoid, and is often done on signs and symptoms.
Treatment with antibiotics can short the illness and reduce the chances of death. There is some antibiotic strains however.
The good news is it can be prevented. Being careful about the food and water you ingest is critical as well as good hand washing. Avoid ice, even in drinks. Drink bottled drinks. Eat only food that is cooked throughly under sanitary conditions. 2 vaccines are also available and recommended for travelers who are at increased risk. There is an oral vaccine that is a live attenuated (weekend) vaccine, and a "dead" vaccine that is an injection. The vaccines are 50-80% effective. There are different reasons to use these two vaccines and you should call to make an appointment to discuss this to determine which vaccine is right for you, and to determine if it is needed for your destination. Vaccines provide immunity for 2-5 years depending on the vaccine you receive.
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