CAUSES, SYMPTOMS & TREATMENT – TYPHOID FEVER
WHAT IS TYPHOID FEVER?
Typhoid fever is an infectious disease caused by the consumption of water and raw or under cooked food that have been contaminated with the feces of an infected person. The symptoms of the disease include a long acute fever, body weakness, abdominal pain, headaches and loss of appetite. In some cases, constipation and skin rash appear. Very rarely, internal hemorrhages and death can occur.
WHAT IS THE RISK FOR TRAVELERS?
Typhoid fever is common in developing countries but doesn’t occur in industrialized regions, such as the United States, Canada, Western Europe, Australia and Japan. The travelers going to Africa, Asia and South America face the highest risk of being infected with the disease. Each year, 21 million cases of typhoid fever are reported worldwide, including more than 200 000 deaths. In the United States, approximately 300 travel-related infections with typhoid fever are recorded every year.
HOW TO PREVENT TYPHOID FEVER?
Vaccination
There is a vaccine against typhoid fever (available in pill and injectable forms) and you should consider it when traveling, especially if you are going to a country at high risk. Before your departure, see a doctor, he will help you to decide which type of vaccine against typhoid fever is best adapted for you. However, the vaccination against typhoid fever is only 50% to 80% effective. As a result, you must have good hygiene practices and follow basic food safety rules while traveling, even if you are vaccinated.
Food
Always eat well cooked food and consume it while it is still hot. This is especially important for meat, fish and eggs. Clean and peel fruits and vegetables before preparing them or eating them. Never consume unpasteurized dairy products. Avoid street food and bush meat, especially from monkeys and bats.
Water
Always make sure that the water you drink and use is safe. Preferably drink sealed bottled water. If you need to use water from the tap or from a well, you must boil it or treat it with a chlorine-based purification product before you can drink it. Don’t use ice cubes and don’t consume flavored ice and popsicles, unless you are sure that they have been made with safe water.
Hygiene
Frequently wash your hands with clean water and soap, or with a hand sanitizer containing at least 60% alcohol. Never touch your face, especially your eyes, your nose and your mouth, if you are not sure that your hands are clean. When sneezing or coughing, cover your mouth and your nose with a disposable tissue, never with your hands. Throw the tissue in a bin right after use. Stay away from infected (or suspected of being infected) persons. Avoid close contact such as hugs or kisses, and never share eating utensils or cups.
What organs can typhoid affect?
Since typhoid is a bacterial infection it doesn’t affect one specific organ; instead, it attacks multiple organ systems in the body. After the infection, bacteria reach the bloodstream from where it reaches different organs thus causing various symptoms. The gastrointestinal tract is more severely affected including liver, spleen, and muscles. Through bloodstream, bacteria can also reach gallbladder, lungs, and kidneys.
Who should get the typhoid fever vaccine?
- Typhoid vaccination is recommended to:
- Laboratory workers who handle Salmonella typhi bacteria
- Travelers who plan to visit countries prone to typhoid infections, especially if visiting smaller towns and rural areas
- People who are in close contact with a typhoid carrier
Who should not get the typhoid vaccine?
Typhoid vaccination is not recommended to:
- Children who don’t meet the minimum age requirement for vaccination (see below)
- Persons with an illness that involves high temperature or fever
- People who have experienced a severe reaction to typhoid vaccine in the past
- Individuals whose immune system is weakened due to diseases, viruses, etc. (oral vaccination)
- People who are currently taking antibiotics (oral vaccination)
What is the minimum age requirement for typhoid fever vaccine?
Typhoid shot should not be given to children younger than two years of age. On the flip side, live typhoid vaccine (oral) should not be given to a child who is younger than 6.
How long before a trip do you have to get a typhoid vaccine?
Bearing in mind protective effects of typhoid vaccine occur seven days after vaccination, it is recommended to get a vaccine two weeks or, ideally, a month prior to your travel in order to allow the shot to work.
How long does the typhoid fever vaccine last?
Typhoid vaccine is 50% to 80% effective measures of prevention of the infection. That being said, no vaccine is 100% effective, and it is not a substitution for paying attention to what you eat and drink. In other words, while typhoid vaccine can reduce your risk of infection, you still need to be careful and employ prevention tips mentioned above.
What are the side effects of typhoid vaccine?
Even though the vaccine is effective, some side effects are possible. The most common adverse reactions to typhoid vaccine are:
- Feeling of discomfort
- Fever
- Headache
- Muscle pain
- Pain, swelling, and redness at the site of injection
In rare occasions a person may also experience side effects such as:
- Hives
- Itchy feet and hands
- Skin redness, particularly around ears
- Sudden and severe tiredness and weakness
- Swelling of face, eyes, and inside of your nose
How many shots are needed?
Typhoid vaccine can be administered via injections and orally in the form of capsules or tablets. Inactivated typhoid vaccine shot is given in a single dose, i.e., one shot is enough for protection. On the flip side, three tablets are necessary for people in Australia and Europe while Canadians and Americans need four capsules. In Australia and Europe, tablets are taken on days 1, 3, and five while in North America four tablets are ingested on days 1, 3, 5, and 7.
How long does it last for?
One dose of injectable vaccine provides protection for 2 to 3 years after which a booster dose is needed for people who are at risk. In high-risk countries or regions, protective efficacy 1.5 years after vaccination is 72% while three years later it drops to 50%.
When it comes to the oral typhoid vaccine, the series is repeated every year from persons traveling from non-endemic to endemic countries and every three years for people who live in the high-risk regions. For people from Canada oral revaccination is recommended after seven years while Americans revaccinate after five years.
What are the infected areas in the world?
Typhoid fever is widespread across the globe, but it is less common in industrialized parts of the world such as Western Europe, the United States, Canada, Japan, and Australia. Part of the world with the highest risk of infection is in South Asia. However, infections also occur in other parts of Asia, Africa, and Latin America.
What is the transmission seasonality?
A person can get typhoid fever throughout the year, but the infection is particularly common during summer. It could be due to the fact typhoid mainly affects regions with poor sanitation and bacteria spread faster in warmer weather.
When and where was the last outbreak of typhoid?
According to the WHO, last typhoid outbreak occurred in Uganda in 2015. At the beginning of the said year, the outbreak started in Kampala City, and by March 5, about 1940 cases of the infection were identified. From Kampala, typhoid fever outbreak spread to neighboring cities and regions affecting primarily men ages 20 to 39. However, that wasn’t the last outbreak of this infection. In November 2016, typhoid outbreak started in a city called Hyderabad, Pakistan. The biggest problem regarding this latest outbreak is the fact it was caused by drug-resistant superbug strain. Despite the lacking of official data, it is estimated that 800 cases of the infection were detected.
IF YOU THINK THAT YOU MAY BE INFECTED :
If you feel sick after traveling in a country at risk and you think that you may be infected with typhoid fever, you must see a doctor as soon as possible. Inform him/her of the places you have visited.
We make every effort to ensure that the information posted on our website is up to date and accurate according to the latest public health recommendations; however, it is impossible for us to make changes on a daily basis.
For the most current travel health recommendations, please call our clinic as make an appointment with one of our travel health professionals.
