The Vaccine Center is a preventative health and wellness company and strongly recommends that everyone traveling to a country where Typhoid fever is highly prevalent should receive a vaccination against Salmonella typhi bacterial infection. No country currently requires vaccination as a condition for entry. However, health authorities such as the CDC, WHO, PAHO, the London School of Tropical Medicine and Hygiene and others, strongly recommend vaccination for many countries or for certain conditions of travel.
Required vs Recommended:
The Typhoid Fever vaccine is not required by any country at this time. This means that a person is permitted to enter the country whether or not they have received a vaccination against typhoid. A recommended vaccine is not required but most health authorities feel that a person should receive the vaccine as the likelihood and severity of disease clearly outweighs any risk from vaccination.
What is Typhoid Fever?
Typhoid fever is a bacteria that lives in human intestines and sewage dumps. In some cases the infected person does not realize they are infected and suffer only mild symptoms of disease. Such persons are termed “carriers”. Carriers can later prepare uncooked food (such as salad) for another person who is susceptible to typhoid infection. Signs of infection usually occur about 10 – 14 days after eating the infected food. Once infected, a susceptible person may experience constipation or diarrhea, headache, skin rash and fevers up to 104F. The disease can invade the blood stream or perforate the intestines causing systemic illness and death.
According to the CDC, 75% of all cases of typhoid fever in the USA are acquired while traveling internationally. Typhoid fever is still common in the developing world where it affects about 21.5 million persons each year. For this reason the CDC recommends the following simple rule: Boil it, cook it, peel it, or forget it”
- 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.
Some History of Typhoid Fever:
In the early 1900’s the famous case of Mary Mallon or “Typhoid Mary” occurred in the New York area. In summary, Mary was a distinguished housekeeper and cook hired by a number of wealthy families. Unfortunately, the concept that microscopic germs could cause disease was a very new and controversial idea. Mary carried the bacteria but did not know it and consequently is believed to have infected and inadvertently caused severe illness and death of a number of people. Public Health authorities cultured the bacteria and traced it to Miss Mallon. It was the first case of typhoid transmission in the USA.
Where is Typhoid Fever?
Typhoid exits virtually anywhere there are human beings. However, the incidence is much higher in the countries illustrated by the map above. Also, typhoid fever can breakout in any country under conditions such as flooding, overcrowding or wherever hygiene and hand washing breakdown.
Sources: CDC’s Fact sheet about typhoid fever and WHO’s Fact sheet about typhoid fever
The Typhoid Vaccine:
There are 2 types of Typhoid Vaccine: Oral and Intramuscular. The second type is the well known needle injection into the arm and contains no living organism. The oral vaccine comes in 4 capsules and contains living bacteria that has been “attenuated” and does not cause disease. The needle injection generally lasts 2 years; the advantage of the oral vaccine is that it provides protection for up to 5 years.
How To Save Money And Get Better Service By Choosing The Right Travel Medicine Clinic:
- Only go to clinics that offer both vaccines and prescriptions. For many itineraries, including Central or South America, Africa, the Middle East, and Asia, CDC guidelines require both vaccinations as well as prescriptions. For your trip, you may need prescriptions for malaria, travelers’ diarrhea, jet lag, and high-altitude illness prevention. Some vaccine clinics do NOT offer prescriptions. Always ask the clinic if they do both. Otherwise, you may have to pay for two office visits or administrative fees, not to mention the time and inconvenience of having to make two trips to two clinics. Worse yet, you may go on your trip without knowing you need a prescription.
- Only go to clinics that carry all the vaccines available in the United States. Ask the clinic if they carry hard to find vaccines such as Oral Typhoid, Japanese Encephalitis, or Rabies vaccine. Often, some clinics do not carry all vaccines, or they special order them once they find a client. The Vaccine Center has all vaccines available in the United States in stock.
- Only go to clinics that offer you access to a physician if you need it. Ask the clinic if there is a physician you can talk to if you need to. Sometimes people have complex medical issues that require physician input. The Vaccine Center offers access to board- certified physicians if needed.
- Only go to clinics that can offer you in-house blood tests to check your immunity to vaccines you know you already had, or have been exposed to in your life. Always ask the clinic if they offer blood titer testing on premise. In some cases, you may not need the vaccine. A blood test (blood titer) can cost a fraction of getting the vaccine again. Further, The Vaccine Center blood titer testing prices are a fraction of most major labs and we do the blood draw right in our clinic.
- Only go to clinics that focus only in vaccine medicine. Many so called “vaccine clinics” also do urgent care, primary care, occupational medicine, or other unrelated medical services. The Vaccine Center does no primary care or other unrelated medical services.
- Only go to clinics that offer the Yellow Fever vaccine every day. Some clinics offer this only once every week or two. Ask the clinic if they offer Yellow Fever vaccines every day. Since Yellow Fever is required for entry in many countries, this vaccine may be mandatory for your trip. Also ask the clinic if they are qualified to give you a formal “Yellow Fever Exempt Letter” if you have contraindications to getting the Yellow Fever vaccine.
- Only go to clinics that do not charge an administrative fee for follow up visits for vaccines in a series. Always ask if there is an administrative / office fee for subsequent visits. All Vaccine Center follow-up visits for vaccines in a series are not assessed an administrative or office visit fee.
The Vaccine Center and Travel Medicine Clinic has ALL the recommended and/or required vaccines needed for your travel.
- Hepatitis A
- Hepatitis B
- Hepatitis A/B (Twinrix)
- Japanese Encephalitis
- Meningococcal (MenB)
- TD/Tdap (Tetanus)
- Typhoid IM
- Typhoid Pills
- Yellow Fever
- Gardasil (HPV)