Typhoid Vaccination

Typhoid is an infectious disease caused by the bacteria Salmonella typhi which causes severe symptoms in the digestive system. It can be life-threatening, but if treated early antibiotics are effective.

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Typhoid is found in countries with inadequate sanitation and is endemic in Indian subcontinent, South East Asia, parts of the Middle East, Central and South America and Africa. Around 22 million cases of typhoid fever and 220,000 deaths occur annually (WHO 2014). 


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Transmission

The disease is transmitted from human to human via ingesting contaminated food or drinking water or through poor personal hygiene, such as lack of hand washing. The bacteria is found in the faeces of infected individuals and 2-5% of those infected become long term carriers and excrete the bacteria in their faeces.

What are the symptoms of typhoid?

The incubation period is 10 to 20 days and depends on, among other things, how large a dose of bacteria has been taken in.
In the mild disease, the bacterium is eliminated very early in the course of the disease and there are perhaps only mild symptoms.

Symptoms can include high fever, diarrhoea or constipation, headache, rash and in severe disease multi-organ failure can occur.  If untreated, the death rate is 20%, whereas prompt antibiotic treatment reduces this to less than 1%.

Treatment

Typhoid is treatable with antibiotics administered early on. Supportive treatment, such as rehydration are also important.

Prevention

Food and water hygiene measures while travelling are important as is maintaining personal hygiene.

Vaccination is available to those at risk of typhoid fever.

The typhoid vaccine is made from inactivated protein from the bacteria. It cannot cause infection in the vaccinated individual and nor is the vaccinated individual infectious to others. The inactivated vaccine is effective from 7 days and provides around 75% protection against the illness. There is a live vaccine that is taken orally, which is 50-60% effective. However, this is rarely indicated as it requires 3 doses, can only be given from 6 years of age and is not as effective as the inactivated injection.

Can children have the typhoid vaccine?

Yes, children over a certain age (usually 2 years for the injectable vaccine and 6 years for the oral vaccine) can receive the typhoid vaccine.

 

Age range Method of Administration Number of doses
From 2 years of age Intramuscular injection to the deltoid muscle 1 dose

Booster Doses

There is no booster vaccination for typhoid, instead a new vaccination should be given every 3 years for ongoing risk.

 Who is not able to have the typhoid vaccine?

The vaccine is not recommended for individuals with severe allergies to any vaccine components or those with a compromised immune system.

The inactivated vaccine should not be given if:

  • There is a history of severe allergic reaction to previous dose of typhoid vaccine or any of the components of the vaccine.
  • In illnesses with fever above 38.5 degrees Celsius.

Pregnancy

There is no specific data on the safety of the inactivated typhoid vaccine during pregnancy. However, inactivated vaccines have not been shown to cause harm during pregnancy. Therefore, the vaccine can be  administered to pregnant women who are at significant risk of exposure to Typhoid during travel following a careful risk assessment.

Breast Feeding

There is no specific data on the safety of the inactivated typhoid vaccine when given to breast feeding mothers. However, inactivated vaccines have not been shown to cause harm when given to breast feeding mothers.  Therefore, the vaccine can be administered to pregnant women who are at significant risk of exposure to Typhoid during travel following a careful risk assessment.

Common Side Effects

Local reactions at injection site-pain, redness, swelling.

Fever, nausea and vomiting, abdominal pain, headache and muscle ache can occur after vaccination and are normally short lived.

How does typhoid interact with other vaccines?

Typhoid vaccines can generally be given alongside other travel vaccines, but scheduling and interactions should be discussed with a healthcare provider.

Typhoid vaccine is recommended for travellers to areas where typhoid is common, particularly in parts of Asia, Africa, and Latin America. It’s also advised for people who have close contact with an infected person.

The typhoid vaccine’s protection typically lasts about 3 years. After this period, a booster dose is needed for continued immunity.

A typhoid booster is recommended every 3 years for those who remain at risk, either through travel or other exposure.

High-risk areas include parts of South Asia, Southeast Asia, Africa, the Caribbean, and Central and South America.

The cost of each typhoid vaccination dose is £44. Initially, there is an additional base fee of £20 which covers time spent with one of our specially trained healthcare professionals who will carry out a risk assessment.

Common side effects include pain at the injection site, fever, and headache. Rare side effects can include severe allergic reactions.

The typhoid vaccine is usually not free on the NHS for travel purposes. However, it might be available for specific clinical indications.

1) What are the contents of the inactivated Typhoid vaccines?

Typhim Vi contains the following ingredients

  • Phenol (preservative)
  • Sodium Chloride
  • Disodium phosphate dihydrate
  • Sodium dihydrogen phosphate dihydrate
  • Water for Injections

The vaccine does not contain

  • Egg products
  • Thiomersal
  • Latex
  • Gelatin

2) Why can the vaccine not be given to children under 2 years?

The reason for this is that the typhoid vaccine is a polysaccharide vaccines and children under 2 years do not mount a good immune response to the vaccine. Therefore, they are not as effective.

3) Why is a new vaccination required after 3 years?

The immunity from the typhoid vaccine wanes over this period of time. Therefore, if there is further risk of exposure due to travel, a new vaccination is required to increase the protection levels.

4) How effective is the Typhoid vaccine?

The inactivated vaccine is around 75% effective. This may be less if a large number of bacteria is ingested. Therefore, it is important that in addition to vaccination, you are scrupulous with food and water and hand hygiene while travelling.

Written by Travel Health and Vaccination Lead Derek Evans

Travel Vaccinations

Whether you are going on a honeymoon, trekking or going on a last minute business trip, we can provide you with a comprehensive travel clinic service. Our specialist nurses and pharmacists offer vaccinations for travel to any country in the world, as well as destination specific health advice tailored to your itineraries. Click here for a full list of vaccinations we offer. Please note: Parents or legal guardians will need to directly accompany any child who is being vaccinated and bring along a photo ID for themselves.

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Pre-Travel Advice

Our pre-travel consultations are with experienced travel health specialists and pharmacists who will assess the impact of any pre-existing medical conditions along with your vaccine requirements. They will discuss in detail countries at risk, precautions you can take to avoid exposure and how to travel safely. We also highly recommend visiting the government websites which has the latest travel news and advice for every destination.

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