Read below for travel health advice on diseases and special needs from the MDtravelhealth channel.
Typhoid fever is caused by ingestion of food or water contaminated by a species of Salmonella known as Salmonella typhi. The organism may persist in the stool after signs of illness have resolved and may be passed to others if personal hygiene is poor, especially if the individual is involved in preparing food. The incubation period usually ranges from one to two weeks, but may be as long as two months. Fever occurs in virtually all cases. Other symptoms may include headache, malaise, muscle aches, dizziness, loss of appetite, nausea, and abdominal pain. Either diarrhea or constipation may occur. Possible complications include intestinal perforation, intestinal bleeding, confusion, delirium, or rarely coma. Because reports of resistance to older antibiotics are becoming more frequent, typhoid fever is usually treated with one of the quinolone antibiotics, such as ciprofloxacin or levofloxacin, generally by mouth. An alternative drug is ceftriaxone, which must be given by injecton.
Typhoid vaccine is generally given in an oral form (Vivotif Berna) consisting of four capsules taken on alternate days until completed. The capsules should be kept refrigerated and taken with cool liquid. Protection is achieved seven days after the last dose. Side-effects are uncommon and may include abdominal discomfort, nausea, and rash or hives. Oral typhoid vaccine should not be taken with antibiotics, because they may interfere with its effectiveness. If all four doses are not taken, the entire series must be restarted to achieve protection.
The alternative is an injectable polysaccharide vaccine (Typhim Vi; Aventis Pasteur Inc.) (PDF) given as a single 0.5 cc intramuscular injection. Immunity is conferred seven days after vaccination. Adverse reactions, which are uncommon, may include discomfort at the injection site, fever and headache. In February 2005, the manufacturer announced a temporary shortage of the injectable vaccine, which it attributed to increased demand and which it expected to last until early April 2005.
The oral vaccine is approved for travelers at least six years old, whereas the injectable vaccine is approved for those aged two or above. A liquid formulation of the oral vaccine has been shown to be effective in children as young as two years old, but has not yet been approved in the United States. The efficacy of both vaccines appears comparable, generally 50-70% in different studies. Boosters are recommended after five years for the oral vaccine and two years for the polysaccharide vaccine.
The safety of typhoid vaccine during pregnancy is unknown. If typhoid immunization is necessary during pregnancy, the injectable polysaccharide vaccine (Typhim Vi) is probably preferable, because it does not contain live bacteria. Oral typhoid vaccine is safe in HIV-infected individuals as long as their CD4 lymphocyte counts remain above 200.
Breastfeeding is probably protective against typhoid fever in infants.
Because the efficacy of typhoid vaccine is limited and because many other infections can be acquired from contaminated food and beverages, immunization against typhoid does not in any way diminish the importance of following food and water precautions.
From the World Health Organization (WHO)
Typhoid vaccines (PDF) (WHO position paper)
From the Centers for Disease Control (CDC)
Typhoid Fever (Yellow Book)
Do you have any comments on this resource page? We want to tell the Red Planetter community about this condition or advice.
You don't need an account or have to sign up or anything!
Is there anything missing that you know about? Or can you offer any insightful tips from your experience?
If you are not logged in, or choose to make the drop box anonymously you can tell the community honestly what you seen without any concern. Please send images or other evidence to support your claims.
The MDtravelhealth channel is a source of travel health information for travellers, written by medical professionals.
The MDtravelhealth channel relies on medical professionals from all over the world to maintain the Travel Health Information on these pages.
Topic Tags are what bind the Red Planet Travel site together, and are very important.
This place has been tagged:
Before you apply read about the Medical Professionals Roles on Red Planet TravelYou need to be logged in and have applied to MDth channel to contribute to this page.
We are looking to grow the information on this site, if you have something to contribute to any page then we'd like to hear from you.
What's more you can now earn money (paid direct via Paypal) for writing descriptions about places you know.
You will need to tell other members about yourself and your relevant knowledge and experience about what you want to contribute about.
Look below for some example page types, and types of people whose views on a place might be useful to know.
Page Type: Hotel
Tell us your job, knowledge, experience..
My Experience: Doctor
If you are the owner/manager of any place, then you can, of course, take control of your page and add relevant information other visitors might want to know