Typhoid along with cholera, is one of the most dangerous forms of food poisoning which can be contracted travelling in developing countries. It causes a much more severe illness than other salmonella. It is most common South Asia (India, Nepal, Pakistan, Sri Lanka) but also occurs in much of South East Asia, as well as the rest of the developing world. Salmonella typhi is the bacterium and while it can be treated with antibiotics, this is becoming increasingly difficult due to widespread antibiotic resistance. It is related to other salmonella illnesses but causes a much more serious illness with complications.
Vaccination is recommended for at risk countries.
The symptoms of the illness consist of a high and persistent fever, abdominal pain, sometimes a rash, and paradoxically, constipation rather than diarrhoea! Untreated it can result in death, though some people can carry the infection and remain well. In fact, it is these carriers who spread the disease through poor hygiene associated with food preparation.
Food, water and hand hygiene are very important, in particular selecting meals which are freshly prepared, cooked to order, and served hot in a busy and clean environment. The typhoid vaccine provides further protection and is recommended for most travel to developing countries. The vaccine is generally well tolerated, provides 85%+ protection and lasts 2.5-5 years depending on which vaccine is used.
A single injection will provide two to three years of cover. A course of 4 capsules can provide up to 5 years of protection. Whilst not providing complete cover, it’s still very important to reduce the risk of a potentially serious disease that is becoming increasingly difficult to treat.
The injection is much simpler than the oral capsules. There are some differences in side effects, duration and cost so ask your travel doctor for advice.
The injection can be given separately but is often combined with Hepatitis A vaccine as the risk areas are similar.
While anyone can develop typhoid, small children and older patients have the most complications. Travellers visiting family and relatives in South Asia are shown to be at the highest risk.