I needed a booster this year and read up on the CDC website for this disease:

Typhoid fever is a life-threatening illness caused by the bacterium Salmonella Typhi. In the United States about 400 cases occur each year, and 70% of these are acquired while traveling internationally. Typhoid fever is still common in the developing world, where it affects about 12.5 million persons each year.

Salmonella Typhi lives only in humans.

Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. In addition, a small number of persons, called carriers , recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed S. Typhi in their feces (stool).

You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding S. Typhi or if sewage contaminated with S. Typhi bacteria gets into the water you use for drinking or washing food. Therefore, typhoid fever is more common in areas of the world where handwashing is less frequent and water is likely to be contaminated with sewage.

Once S. Typhi bacteria are eaten or drunk, they multiply and spread into the bloodstream. The body reacts with fever and other signs and symptoms.

Typhoid fever is common in most parts of the world except in industrialized regions such as the United States, Canada, western Europe, Australia, and Japan. Therefore, if you are traveling to the developing world, you should consider taking precautions. Over the past 10 years, travelers from the United States to Asia, Africa, and Latin America have been especially at risk.

Two basic actions can protect you from typhoid fever:

1. Avoid risky foods and drinks.
2. Get vaccinated against typhoid fever.

It may surprise you, but watching what you eat and drink when you travel is as important as being vaccinated. This is because the vaccines are not completely effective. Avoiding risky foods will also help protect you from other illnesses, including travelers' diarrhea, cholera, dysentery, and hepatitis A.

If you drink water, buy it bottled or bring it to a rolling boil for 1 minute before you drink it. Bottled carbonated water is safer than uncarbonated water.

Ask for drinks without ice unless the ice is made from bottled or boiled water. Avoid popsicles and flavored ices that may have been made with contaminated water. Eat foods that have been thoroughly cooked and that are still hot and steaming. Avoid raw vegetables and fruits that cannot be peeled. Vegetables like lettuce are easily contaminated and are very hard to wash well.

When you eat raw fruit or vegetables that can be peeled, peel them yourself. (Wash your hands with soap first.) Do not eat the peelings.
Avoid foods and beverages from street vendors. It is difficult for food to be kept clean on the street, and many travelers get sick from food bought from street vendors.

If you are traveling to a country where typhoid is common, you should consider being vaccinated against typhoid. Visit a doctor or travel clinic to discuss your vaccination options.

Remember that you will need to complete your vaccination at least 1 week before you travel so that the vaccine has time to take effect. Typhoid vaccines lose effectiveness after several years; if you were vaccinated in the past, check with your doctor to see if it is time for a booster vaccination. Taking antibiotics will not prevent typhoid fever; they only help treat it.

I was given the Ty21a (Vivotif Berna, Swiss Serum and Vaccine Institute) 1 capsule by mouth with 4 doses taken at 2 day intervals, to be done at least two weeks prior to travel. It is good for 5 years and the vaccine is a live virus!

The other option, an injection of ViCPS (Typhim Vi, Pasteur Merieux) is good for 2 years.

The parenteral heat-phenol-inactivated vaccine (manufactured by Wyeth-Ayerst) has been discontinued.

What are the signs and symptoms of typhoid fever?

Persons with typhoid fever usually have a sustained fever as high as 103° to 104° F (39° to 40° C). They may also feel weak, or have stomach pains, headache, or loss of appetite. In some cases, patients have a rash of flat, rose-colored spots. The only way to know for sure if an illness is typhoid fever is to have samples of stool or blood tested for the presence of S. Typhi.

What do you do if you think you have typhoid fever?

If you suspect you have typhoid fever, see a doctor immediately. If you are traveling in a foreign country, you can usually call the U.S. consulate for a list of recommended doctors.

You will probably be given an antibiotic to treat the disease. Three commonly prescribed antibiotics are ampicillin, trimethoprim-sulfamethoxazole, and ciprofloxacin. Persons given antibiotics usually begin to feel better within 2 to 3 days, and deaths rarely occur. However, persons who do not get treatment may continue to have fever for weeks or months, and as many as 20% may die from complications of the infection.

Typhoid fever's danger doesn't end when symptoms disappear

Even if your symptoms seem to go away, you may still be carrying S. Typhi. If so, the illness could return, or you could pass the disease to other people. In fact, if you work at a job where you handle food or care for small children, you may be barred legally from going back to work until a doctor has determined that you no longer carry any typhoid bacteria.

If you are being treated for typhoid fever, it is important to do the following:

Keep taking the prescribed antibiotics for as long as the doctor has asked you to take them.
Wash your hands carefully with soap and water after using the bathroom, and do not prepare or serve food for other people. This will lower
the chance that you will pass the infection on to someone else.

Have your doctor perform a series of stool cultures to ensure that no S. typhi bacteria remain in your body.

OT. Some very interesting stuff, Ann. You mentioned the fact that some people are carriers of the disease, but don't contract it themselves. Perhaps the most famous such person was Mary Mallon, who later came to be known as "Typhoid Mary." Here is a link to her story. Link to story.

More reading

It's a nasty disease and one you could very likely pick up in Africa.

quote:

Originally posted by Aspen Hill Adventures:
It's a nasty disease and one you could very likely pick up in Africa.

Well folks, I contracted Typhoid fever at the age of 12 yrs, and I'm lucky to have survived. They didn't have the drugs they have today, and I was unconcious for 12 days, and in bed for a month. It took the next school year to get over this bug. I'm here to tell you this is a decease you don't want! You need to do what ever it takes to avoid it, I assure you!

Between you guys and my wife, I may have to cave in and go get checked. She's after me about Leptospirosis, and Typhoid is a fear right now in Mumbai following the flood. I had to drag my way through 8 kilometers of waist and chest deep flood-water during two days of getting too and from work. I feel fine. I had one bad day about four days after the event. I couldn't hold anything from either end. It's been a week now. If I feel good for a few more days I suspect I'm in the clear.

When Mumbai floods you are struggling through the equivalent of a huge toilet. No question about that.

Kensco, I have to imagine your job pays you real well for your sacrifices. And you're probably a Typhoid carrier!!! I've never quite understood how the tropics seem to carry so many BAD diseases and yet people still manage to flourish in high numbers.

I've marveled at the same thing in the last few days. There are 17 million people in Mumbai and I swear a million of them live and die on the street. They are tougher than a boot. I bet the life expectancy must be about 35 for that caste though. Infant mortality has got to be huge. Not an ounce of body fat and the women in saris working right alongside the men in the ditches. Brutal!

Thanks for all of the advice. This is what makes AR valuable reading.

quote:

Originally posted by Kensco:
If I feel good for a few more days I suspect I'm in the clear.

Kensco,

With typhoid, you can sometimes feel better for short peroids of time, and then get worse again. It's best to be tested just in case as the symtoms are a bit diffuse, and thus not easy to self diagnose. Both my wife and I had typhoid with driving thru africa, and it was a very dibilitating disease. We eventually felt very weak. Especially my wife, who had a more serious case than I. We don't know how long we went with it, but probably about a month, maybe a bit longer. It was when we finally were able to get to a clinic that was reasonably equiped in Swaziland (and then again in Nelspruit, RSA where they did a full test on both of our blood and stools to see what else we might have) that we found out what the problem was.

And we were both vaccinated against it from before, so it just goes to show that no vaccine is 100% sure...

Hope you get well soon.

The only real risk in southern Africa is if you are hunting crocs- they are natural carriers. Don't I know, caught Typhoid whilst catching live crocs in the Mawenda bay of Kariba in '87. We were handeling them alot, and stomach pumping them to anylise diet but three out of five of us went down.