What Is Typhoid?

Typhoid, or typhoid fever, is a serious and potentially fatal illness caused by specific bacteria.

Typhoid can be prevented by a vaccine. Although the typhoid vaccine is effective, it cannot prevent 100% of typhoid infections.

Typhoid fever does occur within the US; however, it is more common in developing countries where water is likely to be contaminated by bacteria. It is important, particularly when traveling in Asia, Africa, and Latin America, to be aware of possible bacteria contamination of food and water.

The bacterium is contracted through drinking water that has been contaminated with sewage. It can also be ingested by eating food that has been washed in bacteria-laden water.

The most common symptoms of typhoid include:

• High fever, usually up to 103˚F or 104˚F
• Weakness
• Fatigue
• Stomach pains
• Loss of appetite
• Headache
• Rash

Typhoid is treated with antibiotics. Without treatment, fever and symptoms may continue for weeks or months, and death may occur as a result of complications from the bacterial infection.

What Is the Typhoid Vaccine?

There are 2 types of typhoid vaccines:

• An inactivated vaccine that is injected
• A live, weakened vaccine given orally

The inactivated vaccine is given as a shot. It should not be given to children younger than 2 years old. A single dose should be given at least 14 days before traveling abroad. Booster shots are needed every 2 years for those who continue to be in parts of the world where they would be exposed to typhoid fever.

The live typhoid vaccine is given orally. It should not be given to children younger than 6 years old. Four doses, with a day

separating each dose, are needed. A booster dose is needed every 5 years.

Who Should Get Vaccinated and When?

Although the typhoid vaccine is not given routinely in the US, the following individuals should be vaccinated:

• People who are traveling to areas outside the US where typhoid commonly exists
• People who are in close contact with an individual who has or carries typhoid
• People who work with the bacterium—typically laboratory workers

Boosters of the inactive vaccine are required every 2 years for people at risk of contracting typhoid, and every 5 years for those at risk who take the oral vaccine.

For maximum effectiveness, the vaccine should be taken 2-3 weeks prior to the potential exposure the bacterium.

What Are the Risks Associated With the Typhoid Vaccine?

Common side effects of the vaccine given by injection include:

• Fever
• Headache
• Redness or swelling at injection site (inactivated only)

Common side effects of the oral vaccine include:

• Fever
• Headache
• Abdominal pain
• Nausea or vomiting
• Rash

Side effects that may indicate a serious allergic reaction include:

• Changes in behavior
• Extremely high fever
• Difficulty breathing, hoarse voice, and wheezing
• Hives
• Pale skin
• Weakness
• Rapid heartbeat
• Lightheadedness

Who Should Not Get Vaccinated?

• For the shot, the following individuals should not get vaccinated. Those who:
  • Have had a severe allergic reaction to a previous typhoid vaccine or any of its components
  • Are under age 2 years
• For the oral vaccine, the following individuals should not get vaccinated. Those who:
  • Have had a severe allergic reaction to a previous typhoid vaccine or its components
  • Are under age 6 years
  • Are currently taking certain antibiotics
  • Have a weakened immune systems, including HIV/AIDS
  • Are being treated with drugs that can compromise the immune system, such as steroids
  • Have cancer
  • Are undergoing treatment for cancer with medication or

    radiation

Consult your doctor if you are traveling and are at risk for acquiring typhoid fever, especially if you have any of the above conditions.

What Other Ways Can Typhoid Be Prevented Besides Vaccination?

Below are some ways to decrease your risk of getting typhoid:

• Frequent and thorough hand washing, particularly before handling food
• Properly cleaning and preparing food to ensure no contamination
• Avoiding uncooked vegetables or fruit that cannot be peeled
• Boiling water before drinking or using
• Avoiding potentially contaminated food or water

What Happens in the Event of an Outbreak?

If the suspected cause comes from a commercial food-service facility, the facility and employees should be investigated within 24 hours of determining the suspected source.

If the suspected source is a daycare facility, the facility and employees should be investigated and questioned about recent travel and symptoms.

Also, in the event of an outbreak, government agencies should educate the public on ways to prevent the transmission of typhoid, including proper hygiene habits and careful food preparation.

Nelson CB, de Quadros C. Coalition against typhoid: a new, global initiative to advance typhoid vaccination. Vaccine. 2011;29(38):6443.

Typhoid vaccine. US Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/vaccines/hcp/vis/vis-statements/typhoid.pdf
Published May 29, 2012. Accessed June 10, 2015.