Typhoid is a bacterial infection transmitted by food or drink that has been contaminated with human faeces or urine (faecal-oral route). Typhoid can be found throughout the world but it is more common in countries with poor sanitation and hygiene where water or food supplies are more liable to be contaminated, especially Africa, the Indian Sub-continent, South East Asia and South America. In the UK, most people who get typhoid fever have visited India, Pakistan or Bangladesh. Typhoid illness causes a severe systemic infection that can spread throughout the body, affecting many organs. Without prompt treatment, it can cause serious complications and can be fatal.
Prevention is focused on ensuring safe food and water, particularly in countries where typhoid is more common. Foods to be wary of include shellfish, salads, unwashed fruit and vegetables and raw undercooked meat products. Good personal hygiene is also very important. Individuals should ensure that they wash their hands prior to eating and after visiting the bathroom. Two main typhoid vaccines are available for typhoid fever in the UK:
- Ty21a vaccine – given as three capsules to take one orally on alternate days
Typhoid vaccine injection for adults is also available in combination with hepatitis A; there is no combined paediatric formulation.
Neither vaccine offers 100% protection against typhoid fever, the Vi vaccine injection is generally considered more effective than the oral Ty21a vaccine. However, some people prefer to have the Ty21a vaccine because it does not require an injection. As the Ty21a vaccine contains live attenuated bacteria it is not suitable for people who have a weakened immune system. It is also not usually recommended for children under six years, whereas children can have the Vi vaccine from two years of age. The protective effect of the Vi vaccine will last for around three years, after which a follow-up booster vaccination will be required. The Ty21a vaccine will last for around one year before a booster dose is required. Ideally, the typhoid vaccine should be given at least one month before travel, but, if necessary, it can be given closer to your travel date.
As with all vaccines the clinical staff will advise during the travel consultation on all aspects of the procedure including vaccine dose schedule, contraindications to vaccination, any possible interactions with other vaccines or medications, the range of possible adverse effects from the specific vaccine and any queries. Written product information to retain for reference is also provided.