Prevention of Typhoid fever

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A vaccine against typhoid is available but the NHS does not routinely pay for it. The typhoid vaccination is not routinely recommended except for travellers who may be exposed to potentially contaminated food and water in high-risk areas, such as Asia, the Middle East, Africa, Latin America and the Pacific Islands. Vaccination should be given at least two weeks in advance of travelling.

Three typhoid vaccines are available. The first is a whole cell vaccine â€“ one injection will give 70-80% protection for one year. Two doses at intervals of 4 to 6 weeks will provide protection for three years(7). This vaccine is generally only used in less developed countries, because more sophisticated medicines have since been produced elsewhere.

The two vaccines that are now more commonly used are a four-dose oral vaccination and a single dose injection.

The oral vaccine gives about 70% protection. It contains live organisms and must not be given to HIV positive patients or given at the same time as the polio vaccine. (8)

The injection gives 70-80% protection for at least three years. Those at risk should be re-immunised every three years. (9) This is the most commonly used vaccine and has fewer side effects than the oral vaccine.

None of the vaccines give total protection against typhoid and they are not effective against large amounts of the disease. For this reason, it is very important to avoid potentially contaminated food and drink when in areas where typhoid is common. Avoid eating foods that have been kept at room temperature or not been washed (including salads and raw vegetables), and boil water before drinking it.

To prevent the spread of typhoid fever, high standards of hygiene and sanitation must be maintained. Wash your hands before and after eating and after going to the toilet.

Note that vaccination is not suitable for pregnant women, children under six, people with HIV or AIDS or anyone who is currently ill and/or taking antibiotics. You should speak to your GP or call NHS Direct 0845 4647 for further advice, if travelling to a country where typhoid is common.