Typhoid Fever Vaccine

Typhoid fever is a life-threatening illness caused by the bacterium Salmonella Typhi. The infection is uncommon in the United States compared with many other parts of the world, but it remains a significant health concern in regions with limited access to safe drinking water and adequate sanitation.

If you are planning international travel to an area where typhoid fever is common, vaccination can help reduce your risk of infection. Understanding how the disease spreads, recognizing its symptoms, and knowing when to get vaccinated can help you prepare for a safer trip.

What Is Typhoid Fever?

Typhoid fever is a bacterial infection that spreads when people consume food or water contaminated with Salmonella Typhi. The bacteria live exclusively in humans and can enter the bloodstream after being ingested, causing a systemic illness.

According to the Centers for Disease Control and Prevention (CDC), an estimated 9.2 million cases of typhoid fever occur worldwide each year. In the United States, most people diagnosed with typhoid fever acquired the infection while traveling internationally.

How Does Typhoid Fever Spread?

Typhoid fever is transmitted through the fecal-oral route, meaning the bacteria spread when contaminated fecal matter enters a person’s mouth. This can happen when:

• Eating contaminated food: Food may become contaminated if it is handled by someone carrying Salmonella Typhi who has not washed their hands properly.
• Drinking contaminated water: Water contaminated with sewage containing the bacteria can transmit the infection.
• Eating food washed or prepared with contaminated water: Fresh produce and other foods can become contaminated during preparation.

Typhoid fever is more common in areas where sanitation systems and access to safe drinking water are limited. People who have typhoid fever can carry the bacteria in their bloodstream and intestinal tract and shed it in their stool. Some people, known as carriers, continue to harbor and shed the bacteria even after recovering from the illness. This allows the infection to spread to others.

What Are the Symptoms of Typhoid Fever?

Symptoms of typhoid fever typically develop gradually and may include:

• Persistent or prolonged fever
• Weakness and fatigue
• Headache
• Stomach pain
• Diarrhea or constipation
• Loss of appetite
• Cough

Without appropriate treatment, typhoid fever can lead to serious complications, including intestinal bleeding or perforation. The illness can be life-threatening, so anyone who develops symptoms consistent with typhoid fever should seek prompt medical attention, particularly after traveling to an area where the disease is common.

Who Should Get the Typhoid Fever Vaccine?

The CDC recommends typhoid vaccination for travelers going to areas where typhoid fever is common, particularly when their itinerary or activities may increase their exposure to contaminated food or water.

Vaccination may be especially important for people visiting friends or relatives in countries where typhoid fever is prevalent, as well as travelers visiting areas with limited sanitation infrastructure.

When Should You Get the Typhoid Fever Vaccine?

It is important to plan your vaccination before departure so your body has time to develop an immune response. The timing depends on the type of vaccine:

• Injectable typhoid vaccine: The injectable typhoid vaccine is administered as a single intramuscular injection and is approved for people aged two years and older. It should be given at least two weeks before potential exposure. For travelers who continue to face a risk of typhoid fever, a booster dose is recommended every two years. Should be administered at least two weeks before potential exposure.
• Oral typhoid vaccine: The complete four-capsule series should be finished at least one week before potential exposure. The oral typhoid vaccine is a live, weakened bacterial vaccine taken as a series of four capsules. The capsules are taken every other day, and the complete series must be finished at least one week before potential exposure. For people who remain at risk, a booster series is recommended every five years.

A healthcare professional can help you determine which vaccine is appropriate based on your age, medical history, travel plans, and other relevant factors. Because vaccine eligibility and timing vary by product, speak with a healthcare professional well before your trip to determine which option is appropriate for you. For destination-specific recommendations, visit the CDC Travelers’ Health website and select your destination to review recommended travel vaccinations and other precautions.

Other Ways to Prevent Typhoid

Vaccination should be combined with careful food and water precautions when traveling to areas where the disease is common. To reduce your risk of infection:

• Wash your hands frequently with soap and water, especially before eating and after using the restroom.
• Drink bottled or properly treated water when the safety of the local water supply is uncertain.
• Choose food that has been thoroughly cooked and served hot.
• Be cautious with raw fruits and vegetables that may have been washed with contaminated water.
• Avoid food and beverages that may have been prepared under unsafe sanitary conditions.

These precautions remain important even after vaccination.