Typhoid

Transmission
Mainly by food and drink that has been contaminated with excreta of a human case or carrier.

Recommendations for travellers
Recommended for travellers to areas where food and water are likely to be contaminated. When the risk is small vaccination may be limited only to those unable to maintain their own hygieme precautions or staying for long periods.

Vaccination

Always confirm details with manufacturer's literature
OPTION 1 TYPHERIX (SmithKline Beecham)
Type: polysaccaride
Primary course: 1 dose
Dose: 0.5ml
Route: i/m
Boosters: 3 yearly
Side effects: Sometimes sore injection site, mild fever or headache.
Contraindications: Hypersensivity to a previous dose. Febrile illness. Caution in pregnancy and lactation (no data available).
Licenced for use from 2 years of age.

OPTION 2 TYPHIM VI (Pasteur Merieux)
Type: polysaccaride
Primary course: 1 dose
Dose: 0.5ml
Route: s/c or i/m
Boosters: 3 yearly
Side effects: Sometimes sore injection site and mild fever
Contraindications: Hypersensitivty to a previous dose. Febrile illness. Caution in pregnancy and lactation (no data available).
Chidren under 18 months: The response to the vaccine may be suboptimal but good protection is usually achieved.

OPTION 3 VIVOTIF (Medeva Pharma - previously Evans Medical)
Type: Live attenuated
Primary course: 3 doses on days 1,3,5)
Dose: 1 capsule
Route: oral
Boosters: 3 yearly (an annual booster is recommended for high risk travellers)
Side effects: rarely diarrhoea or vomiting, urticarial rash.
Contraindications: fever, pregnancy, immunocompromised, diarrhoea or vomiting, concurrent antimicrobial or malarial therapy. Not for use in children <6yrs.
Notes: This is a live vaccine and the capsules must not be kept out of cool storage (1 to 5 degrees C) for more than 48 hours.
Its administration should be separated from live poliomyelitis vaccine by at least 12 hours.

Note: A previous typhoid illness does not confer reliable immunity and, when indicated, vaccine should still be used.