What is typhoid? 

Typhoid is a serious infection caused by the bacteria salmonella typhi. Typhoid disease results in high fever, loss of appetite, weakness, fatigue, abdomen pain, headache and sometimes a rash. 

All typhoid patients need to be treated, if left untreated it can cause death in up to 30% infected person. Some people who had gotten typhoid before may become carriers and can spread the disease to other people. 

Typhoid is spread by consuming contaminated water or food. It is advisable to get typhoid vaccination for travellers travelling to developing countries where typhoid disease is endemic or if there is poor sanitation. 
Typhoid vaccine 

There are two typhoid vaccines available. One the inactivated form is given as an injection shot. The other the active form is given as an oral form. Either vaccine can be given together with other vaccines. 

1. Inactivated typhoid vaccine shot: It should not be given to children below two years old. One dose is enough for protection but must be given two weeks prior to travel for the vaccine to work. A booster will be given every two years for people who are at continued risk of contracting typhoid. 

2. Live oral typhoid vaccine: It should not be given to patients younger than 6 years old. 
  • Four doses in total: one capsule every other day for a week (day 1, day 3, day 5, and day 7). The last dose should be given at least 1 week before travel to allow the vaccine time to work.
  • Swallow each capsule about an hour before a meal with a cold or lukewarm drink. Do not chew the capsule.
  • A booster is given every 5 years for people who remain at risk of contracting typhoid. 
Who needs typhoid vaccination? 

1. Travellers travelling to countries where typhoid is common. Do note that the typhoid vaccine is not 100% effective against typhoid. Proper food hygiene and sanitation service is important prevention. 

2. Laboratory and research workers who come into close contact with salmonella typhi bacteria. 

3. People who are in close contact with typhoid carriers. 
Contraindications to inactivated typhoid vaccine shot

1. People who had previous severe reaction to typhoid shot/allergy to content of vaccine should not be vaccinated again. 

2. Children younger than two years old. 

3. People who are moderately or severely ill at time of vaccination should deter vaccination until they have recovered. 
Contraindications to live oral typhoid vaccine 

1. People who had previous severe reaction to typhoid shot/allergy to content of vaccine should not be vaccinated again. 

2. Children below 6 years old 

3. People who has weakened immune system such as people with HIV/AIDS infection, on long term steroids, cancer patients or people receiving cancer treatment. 

4. People who are moderately or severely ill at time of vaccination should deter vaccination until they have recovered. 

5. Oral typhoid vaccine should be given at least 3 days after last antibiotic dose. 
What are the side effects of typhoid vaccine?

Serious reaction or anaphylactic reaction to the vaccine is very rare. Should it happen seek medical consultation immediately. Minor side effects may occur such as : 

1. Inactivated typhoid vaccine shot: Mild reactions to vaccine that can occur include headache (1 in 30), fever (1 in 100) and redness or swelling at site of injection ( 1 in 15). 

2. Live oral typhoid vaccine: mild reactions to the oral vaccine include fever or headache (1 in 20) and nausea, vomiting , stomach pain and rash (rare).