Typhoid is contracted from contaminated food or water. UK cases mostly involve visitors to the Indian subcontinent.
Typhoid and paratyphoid result from consuming contaminated food or water, causing enteric fever in low-income regions with poor sanitation and limited clean water access.
Asia has the most global cases, but typhoid remains a concern in Africa, Central and South America.
UK travel-related infections are prevalent among visitors to the Indian subcontinent (Bangladesh, India, Pakistan).
Symptoms of typhoid and paratyphoid include fever, headache, muscle or joint pains, constipation or diarrhoea and a rash. Complications include intestinal bleeding and perforation (development of a hole in the wall of the bowel). If treated most people will make a full recovery however if untreated death rates can be high.
The risk of acquiring typhoid or paratyphoid can be reduced by ensuring good personal hygiene and following advice on the prevention of food and water-borne diseases.
Vaccination is recommended for travellers whose planned activities put them at higher risk of typhoid infection in areas where sanitation and food hygiene are likely to be poor. Vaccinations currently available only protect against typhoid and not paratyphoid infection. Both oral and injectable vaccines are available. Some vaccinations are combined with Hepatitis A.
Public Health England’s Immunisation against infectious disease states: children between the ages of 12 months and two years should be immunised if the risk of typhoid fever is considered high. Immunisation is not recommended for children under one year of age. When children are too young to benefit fully from typhoid vaccination, scrupulous attention to personal, food and water hygiene measures should be exercised by the caregiver.
Following a single dose of an injectable or a complete course of oral typhoid vaccine, reinforcing immunisation should be offered at three-year intervals for those at continued risk. Booster vaccination of oral typhoid consists of 3 further capsules.
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