Need a Vaccination Against Typhoid?
With New Zealand still coming to terms with a typhoid outbreak that killed one woman and affected 22 other people, it’s time to consider your vaccinations if you’re thinking of travelling to a developing country or region.
While New Zealand is far from being classed as underdeveloped, it just goes to show that this disease can show up in some of the most unlikely places.
How typhoid was brought into New Zealand is still a mystery, with the government of the opinion that it could have been via Taro chips imported from Samoa and served at a church function. (The chips are made from the root of the Taro plant, a cousin of the potato).
What is typhoid?
It’s a gastrointestinal illness caused by the Salmonella enterica typhi bacteria. There is also a similar illness called Paratyphoid Fever caused by 3 different paratyphi bacteria. Collectively they all usually known as enteric fever.
How does typhoid spread?
Typhoid is only spread by eating food or drinking water contaminated by the urine or faeces of somebody with the disease, meaning they are infected or are a carrier. Carriers can be someone who has had typhoid and is still otherwise well but shedding the bacteria via their faeces.
Typhoid isn’t likely to be transferred by hugging or kissing someone so people can go about their usual daily activities, but remember good hygiene is vital whether the person is a carrier or not. This is especially so when handling food. Washing hands with soapy water for at least 20 seconds is recommended. Then dry them with a clean paper towel or cloth.
Always do this after:
- Using the toilet
- Before you prepare food
- Before you eat or drink
- And also after changing a baby’s nappy
The risk of someone spreading typhoid once they’re in hospital being treated for it appropriately is very low. However, it can take some days of observation and testing before anyone suffering from typhoid can be cleared by infectious disease doctors to ensure there is no risk they will transmit the disease to others.
- Flu-like symptoms, muscle aches and pains
- Gradual onset of high fever, chills and sweating
- Headaches, nausea, rash
- A lack of appetite, malaise
- Pains in the stomach, constipation (in adults) diarrhoea (in children)
- Dizziness, delirium and confusion
- Convulsions in children under 5
The incubation period for typhoid is usually eight to 14 days but can be up to 80 days so any cases linked to an outbreak can emerge over many weeks.
Which are the countries where typhoid is endemic?
Countries such as the US, Australia, and Great Britain, for instance, where there are proper sanitation services, clean drinking water and vaccination programs, are not risk areas as far as typhoid is concerned. They do occasionally report single cases or small outbreaks that are due to someone returning after travelling to one of the at-risk countries.
However, places of risk are Southeast Asian countries, Africa, the Middle East, Central and South America, and Western Pacific regions without adequate sewerage systems and clean drinking water. Your travel doctor would recommend vaccination if you are travelling to any of these regions.
When it comes to food eaten in typhoid endemic areas the advice is ‘Cook it, boil it, peel it or forget it’.
These are the typhoid vaccines deemed safe and effective and available in Australia:
Monovalent typhoid vaccines
- Vivotif Oral – An oral live attenuated typhoid vaccine. Three capsules in a blister pack.
- Typherix – A purified Vi capsular polysaccharide vaccine. Injectable.
- Typhim Vi – A purified Vi capsular polysaccharide vaccine. Injectable.
Combination typhoid vaccine
- Vivaxim – Inactivated hepatitis A virus and purified Vi capsular polysaccharide vaccine. Injectable.