Vaccine: Typhoid (known as Typhim Vi or Vivotif)
Dose: Typhim – 1 dose. Vivotif – 3 capsules, one taken on alternate days
Route: Typhim – intramuscular injection. Vivotif – Oral Capsule
Booster: Primary course to be completed every 3 years, if risk remains.
Transmission: Spread through contaminated water in areas where sanitation is
poor.
The Typhoid Fever vaccine is a travel vaccination that is often recommended in parts of the world where typhoid is present. Vaccination is suitable for adults and children from 2 years of age and should be used in conjunction with safe eating and drinking habits to minimise the risk of other infections.
Inactivated vaccines like Typhim cannot cause the disease that we are vaccinating against and a single dose of Typhim will confer around 3 years of protection. It can take around 3 weeks for your immune system to develop a good response and booster doses are not required. If you require protection in the future another single dose of Typhim can be administered to again confer 3 years of protection.
In addition to the injectable vaccine Typhim, you can also get an oral vaccine called Virotic.
Vivotif is a live vaccine and the availability of this product is somewhat variable but it is a useful
vaccine that confers good immunity without the need for an injection. Vivotif consists of three
capsules taken over several days.
What is Typhoid?
Typhoid or Typhoid Fever as it is more correctly known is a bacterial infection caused by the
bacteria Salmonella Typhi. Typically this illness is contracted through contaminated food or water
and the symptoms can be likened to a really nasty form of food poisoning. It is estimated that Typhoid fever affects around 11-20 million people every year with death occurring in around 0.5-1% of those infected. Typical symptoms of a typhoid infection include prolonged high fever, fatigue, headache, nausea, abdominal pain and constipation/diarrhoea. Individuals who develop Typhoid Fever are contagious to others, even after an infection has resolved.
Yyphoid is an example of a disease that is a relatively low impact (most patients make a full recovery) but has a high prevalence and burden on society.
How do you get Typhoid?
Typhoid is acquired through consuming contaminated food or water with transmission by the faucal-oral route. This is where individuals who carry the virus in their faeces contaminate the food they are preparing for others due to poor personal hygiene. The disease usually thrives in areas with poor sanitation and where access to safe drinking water is restricted. Typhoid bacteria are consumed they multiply in the gut and then spread throughout the body. Those who recover will not develop long-lasting immunity and it is possible to contract typhoid on multiple occasions.
Whilst prevention of infection is most the appropriate route, it is worth noting that Typhoid can be successfully treated by antibiotics. Unfortunately, resistance to antibiotics is increasing and some antibiotic groups like fluoroquinolones are now less useful.
Why am I at risk of getting Typhoid?
Typhoid vaccination is not part of the NHS childhood immunization schedule which means you are at risk of contracting Typhoid on a trip to an endemic country. Africa, South America and Asia are hotspots for Typhoid fever and it can be difficult to prevent infection in these high-risk regions when you have limited control over the food and water you consume.
How can I prevent Typhoid?
Typhoid is best prevented through vaccination prior to potential exposure, but some other tips that can help prevent infection include:
- Safe drinking water (even for brushing your teeth). Trusted sources of bottled water, Boiled and cooled water.
- Hygiene. Ensure you wash your hands regularly, especially before you eat food and definitely after every trip to the bathroom.
- Beware about the food and drink you consume. Make sure your food is piping hot before eating it, avoid ice in your drinks, avoid salads and only eat fruit that needs to be peeled. Some food like shellfish can be particularly high risk. What side effects could I expect from a Typhoid vaccine?
As mentioned earlier Typhoid vaccines are safe and effective; adverse events are infrequent. Typical adverse events are usually limited to:
- Injection site reactions like a sore arm or redness swelling or tenderness at the injection site
- Low-grade fever (greater than 37.5C)
- Fatigue and Tiredness These symptoms will usually resolve within a few days and require only paracetamol or a cold compress (if swelling at the injection site) to manage them. Side effects from Vivotif capsules are usually limited to stomach upsets like diarrhoea and vomiting but you can also suffer from fever, rashes and a headache postvaccination.
