Typhoid fever primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Aslam, M.B.B.S[2]

Overview

Effective measures for the primary prevention of typhoid fever include vaccination, improving personal hygiene and sanitation,[1] ensuring proper sewage disposal, avoiding overcrowding, and avoiding close contact or sharing utensils with people already suffering from typhoid.[2][3][4][5][6][7][8][9][7]

Primary Prevention

Effective measures for the primary prevention of typhoid fever include:

Vaccination

There are two types of vaccines for typhoid fever:[2][4][5][6][9][7][10]

  • Inactivated typhoid vaccine, ViCPS (IM)
  • Live typhoid vaccine (oral)

Indications[11][12][13][14][6][15]

  • Travel to endemic areas
  • Health care workers or researchers dealing typhoid patients or handling Salmonella typhi
  • Individuals at increased risk of acquiring infection (e.g., household contacts of a patient with typhoid fever)
  • To prevent typhoid epidemic in case of natural disasters or the presence of a refugee camp in an endemic area

Contraindications[16][6][17]

  • Severe allergic reaction to the vaccine component
  • Severely ill or immunocompromised patients
  • Severe reaction to previous dose
  • Children younger than 2 years of age for inactivated vaccine
  • Children younger than 6 years of age for live attenuated vaccine
  • Pregnancy

The table below provides basic information about the typhoid vaccines that are available in the United States:

Typhoid vaccines

Other measures

The following preventive measures help decrease incidence of typhoid in endemic areas:[6][18]

  • Improving personal hygiene and sanitation
  • Implementing proper sewage disposal
  • Avoiding overcrowding
  • Avoiding close contact or sharing utensils with people already suffering from typhoid

The following preventive measures help prevent disease in people traveling to endemic areas:[6][19][20]

  • Avoiding consumption of foods and beverages purchased from street vendors
  • Avoiding consumption of raw fruits and vegetables that cannot be peeled
  • Avoiding consumption of ice cream
  • Eating food which is properly cooked and served hot
  • Using hard cooked eggs
  • Using pasteurized milk products
  • Using boiled or bottled water

References

  1. Ivanoff, Bernard. "Typhoid fever: global situation and WHO recommendations." Southeast Asian Journal of Tropical Medicine and Public Health 26 (1995): 1-6.
  2. 2.0 2.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID http://dx.doi.org/10.1136/bmj.316.7125.110 Check |pmid= value (help).
  3. Wahdan, M. H., et al. "A controlled field trial of live Salmonella typhi strain Ty 21a oral vaccine against typhoid: three-year results." Journal of Infectious Diseases 145.3 (1982): 292-295.
  4. 4.0 4.1 Acharya IL, Lowe CU, Thapa R, Gurubacharya VL, Shrestha MB, Cadoz M; et al. (1987). "Prevention of typhoid fever in Nepal with the Vi capsular polysaccharide of Salmonella typhi. A preliminary report". N Engl J Med. 317 (18): 1101–4. doi:10.1056/NEJM198710293171801. PMID 3657877.
  5. 5.0 5.1 Lin FY, Ho VA, Khiem HB, Trach DD, Bay PV, Thanh TC; et al. (2001). "The efficacy of a Salmonella typhi Vi conjugate vaccine in two-to-five-year-old children". N Engl J Med. 344 (17): 1263–9. doi:10.1056/NEJM200104263441701. PMID 11320385.
  6. 6.0 6.1 6.2 6.3 6.4 6.5 Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ (2002). "Typhoid fever". N Engl J Med. 347 (22): 1770–82. doi:10.1056/NEJMra020201. PMID 12456854.
  7. 7.0 7.1 7.2 MacFadden DR, Bogoch II, Andrews JR (2016). "Advances in diagnosis, treatment, and prevention of invasive Salmonella infections". Curr Opin Infect Dis. doi:10.1097/QCO.0000000000000302. PMID 27479027.
  8. http://wwwnc.cdc.gov/travel/diseases/typhoid
  9. 9.0 9.1 Hainsworth T (2002). "Travel vaccines: a guide to appropriate use". Nurs Times. 98 (25): 40–2. PMID 12168224.
  10. Wahdan, M. H., et al. "A controlled field trial of live Salmonella typhi strain Ty 21a oral vaccine against typhoid: three-year results." Journal of Infectious Diseases 145.3 (1982): 292-295.
  11. John TJ (1995). "Typhoid vaccine". Indian Pediatr. 32 (3): 391–3. PMID 8613306.
  12. http://www.cdc.gov/vaccines/hcp/vis/vis-statements/typhoid.html
  13. Jackson BR, Iqbal S, Mahon B, Centers for Disease Control and Prevention (CDC) (2015). "Updated recommendations for the use of typhoid vaccine--Advisory Committee on Immunization Practices, United States, 2015". MMWR Morb Mortal Wkly Rep. 64 (11): 305–8. PMID 25811680.
  14. Steinberg EB, Bishop R, Haber P, Dempsey AF, Hoekstra RM, Nelson JM; et al. (2004). "Typhoid fever in travelers: who should be targeted for prevention?". Clin Infect Dis. 39 (2): 186–91. doi:10.1086/421945. PMID 15307027.
  15. Tarr PE, Kuppens L, Jones TC, Ivanoff B, Aparin PG, Heymann DL (1999). "Considerations regarding mass vaccination against typhoid fever as an adjunct to sanitation and public health measures: potential use in an epidemic in Tajikistan". Am J Trop Med Hyg. 61 (1): 163–70. PMID 10432074.
  16. Galev A, Nacheva A (2014). "[Pregnancy and vaccinoprevention]". Akush Ginekol (Sofiia). 53 (1): 51–6. PMID 24919344.
  17. http://www.cdc.gov/vaccines/hcp/vis/vis-statements/typhoid.html
  18. Ivanoff, Bernard. "Typhoid fever: global situation and WHO recommendations." Southeast Asian Journal of Tropical Medicine and Public Health 26 (1995): 1-6.
  19. http://wwwnc.cdc.gov/travel/diseases/typhoid
  20. Ahmad Hatib NA, Chong CY, Thoon KC, Tee NW, Krishnamoorthy SS, Tan NW (2016). "Enteric Fever in a Tertiary Paediatric Hospital: A Retrospective Six-Year Review". Ann Acad Med Singapore. 45 (7): 297–302. PMID 27523510.

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