In many developing nations, the public health goals that can help prevent and control typhoid — safe drinking water, improved sanitation and adequate medical care — may be difficult to achieve. For that reason, some experts believe that vaccinating high-risk populations is the best way to control typhoid fever.
The Centers for Disease Control and Prevention recommends being vaccinated if you''re traveling to areas where the risk of getting typhoid fever is high.
Two vaccines are available.
- One is injected in a single dose about two weeks before exposure.
- One is given orally in four capsules, with one capsule to be taken every other day.
Neither vaccine is 100 percent effective, and both require repeat immunizations as vaccine effectiveness diminishes over time.
Because the vaccine won't provide complete protection, follow these guidelines when traveling to high-risk areas as well:
- Wash your hands. Frequent hand-washing is the best way to control infection. Wash your hands thoroughly with hot, soapy water, especially before eating or preparing food and after using the toilet. Carry an alcohol-based hand sanitizer for times when water isn't available.
- Avoid drinking untreated water. Contaminated drinking water is a particular problem in areas where typhoid is endemic. For that reason, drink only bottled water or canned or bottled carbonated beverages, wine and beer. Carbonated bottled water is safer than uncarbonated bottled water is. Wipe the outside of all bottles and cans before you open them. Ask for drinks without ice. Use bottled water to brush your teeth, and try not to swallow water in the shower.
- Avoid raw fruits and vegetables. Because raw produce may have been washed in unsafe water, avoid fruits and vegetables that you can't peel, especially lettuce. To be absolutely safe, you may want to avoid raw foods entirely.
- Choose hot foods. Avoid food that's stored or served at room temperature. Steaming hot foods are best. And although there's no guarantee that meals served at the finest restaurants are safe, it's best to avoid food from street vendors — it's more likely to be contaminated.
Prevent infecting others
If you're recovering from typhoid, these measures can help keep others safe:
Aug. 22, 2012
- Wash your hands often. This is the single most important thing you can do to keep from spreading the infection to others. Use plenty of hot, soapy water and scrub thoroughly for at least 30 seconds, especially before eating and after using the toilet.
- Clean household items daily. Clean toilets, door handles, telephone receivers and water taps at least once a day with a household cleaner and paper towels or disposable cloths.
- Avoid handling food. Avoid preparing food for others until your doctor says you're no longer contagious. If you work in the food service industry or a health care facility, you won't be allowed to return to work until tests show that you're no longer shedding typhoid bacteria.
- Keep personal items separate. Set aside towels, bed linen and utensils for your own use and wash them frequently in hot, soapy water. Heavily soiled items can be soaked first in disinfectant.
- Brunette GW, et al. CDC Health Information for International Travel 2012. Atlanta, Ga.: U.S. Department of Health and Human Services, Public Health Service; 2012. http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/typhoid-paratyphoid-fever.aspx. Accessed April 26, 2012.
- Typhoid fever. Centers for Disease Control and Prevention. http://www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid_fever/. Accessed April 18, 2012.
- Maurice J. A first step in bringing typhoid fever out of the closet. The Lancet. 2012;379:699.
- Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4377-1604-7..00316-X&isbn=978-1-4377-1604-7&sid=1301718288&uniqId=331385541-5#4-u1.0-B978-1-4377-1604-7..00316-X. Accessed April 26, 2012.
- Bope ET, et al. Conn's Current Therapy. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/linkTo?type=bookHome&eid=4-u1.0-B978-1-4557-0738-6..C2009-0-38985-0--TOP&isbn=978-1-4557-0738-6&uniqId=331385541-3. Accessed April 26, 2012.
- Mayer CA, et al. Typhoid and paratyphoid fever. Australian Family Physician. 2010;39:847.
- Crump JA, et al. Global trends in typhoid and paratyphoid fever. Clinical Infectious Diseases. 2010;50:241.
- Humphries RL, et al. Current Diagnosis & Treatment Emergency Medicine. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=55748503. Accessed April 27, 2012.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=9113180. Accessed April 27, 2012.
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