On December 14, 1861, Prince Albert, the beloved husband of Queen Victoria, passed away at the age of 42, with cause of death being typhoid fever. Whilst that may be a disease we associate with those times, it is actually one still suffered by 9 million people a year and a cause of 110,000 deaths.
Whilst, here in the UK, you are not likely to contract this disease, the picture can be very different if you travel to a location in which typhoid fever is still present. This is why being vaccinated against typhoid is so important.
If you are heading off overseas, to anywhere beyond the usual tourist hotspots, it pays to pinpoint exactly what diseases or health issues might be encountered. That is the ethos of the team here at Pinpoint Travel Health, which will help you identify whether or not you require a typhoid vaccination – or, indeed, a typhoid booster – and also advise you of any other travel health precautions that need to be taken.
What is typhoid?
Typhoid fever – also known as enteric fever or just as typhoid – is a potentially life-threatening bacterial infection, caused by the bacterium Salmonella Typhi, that can move through the body, impacting many organs. If untreated, it can lead to internal bleeding, kidney failure, neurological problems, heart inflammation, miscarriage, meningitis, a burst gallbladder and bone inflammation, amongst other things.
It is spread through contact with contaminated food or water and, once the bacteria is ingested, it multiplies and passes into the bloodstream. One-in-five people who get typhoid will die from it and one-in-ten of those who survive will be left with serious complications.[1]
Treatment needs to be administered quickly, which can be an issue in some remote locations, where there is little or no medical infrastructure. Treatment can also be less effective where a patient has developed some resistance to antibiotics.
With climate change, it is likely that we will see a higher incidence of typhoid, with floods creating a greater risk of water contamination for more communities. Another factor that will drive typhoid will be increased urbanisation.
How can a person be impacted by typhoid?
As typhoid is spread by contaminated food and water, it is wise to take good care with what you take on board as ‘fuel’ during your exotic travels. This means boiling water, or drinking bottled water, ensuring the seals on bottles are not tampered with. If they are, it could mean that the bottle was simply filled from a contaminated source. Similarly, do not take ice in drinks, unless you can absolutely trust that it is not contaminated.
You should also be very careful with fresh foods, avoiding fruit, vegetables and salad items that could have been washed in contaminated water. The same is true of utensils.
But typhoid can also be spread when food handlers do not wash their hands before preparing dishes, which can make things very tricky for the traveller. Try to wash fruit and vegetables if they are raw and peel them, if you can.
Wash your own hands thoroughly and regularly, particularly if you have had any contact with pets or animals. Do not be tempted to drink any raw milk.
Which countries offer the highest typhoid risk?
The greatest risk of contracting typhoid is posed to travellers of southern Asian countries, including India, Pakistan and Bangladesh. This makes it particularly important for those who have relatives in these countries and who could make visits over extended periods, perhaps longer than the average holiday time.
However, there is also a risk in other parts of the region, including tourism hotspots such as Nepal, The Maldives and Sri Lanka. Other countries in which typhoid is a notable health risk are Bhutan and Afghanistan.
What vaccinations are there for protection against typhoid?
Since December 2017, the World Health Organisation (WHO) has recognised two typhoid conjugate vaccines. These can be used with children and adults. In the UK, toddlers are typically given an injectable vaccine and an oral vaccine is available to older children and adults.
A typhoid vaccination should be booked at least two weeks before travelling to a region in which the disease is a risk.
If you have previously had a typhoid vaccination, you should not assume that you are still covered by its protection. A typhoid booster may be required, dependent upon when you last had a vaccination.
Knowing whether you need a typhoid vaccination
The Pinpoint Travel Heath service allows you to create your own Travel Health Brief, simply by providing a little bit of information about yourself and your health record and by detailing where you will be travelling or working overseas. It analyses all of that information, using data provided by leading authorities including the World Health Organisation, and uniquely also draws on the expertise of clinical experts within the Pinpoint Travel Health team.
The Travel Health Brief offers clarity with regard to all travel vaccinations and not just typhoid. It will also provide details of any antimalarials required. All of this is after considering the precise geographical area in which you will find yourself, rather than just a region or country. It will also consider any seasonality that might apply to diseases and their arrival in certain areas.
Once you are armed with this brief, you can determine what travel health precautions are required and use the information provided, in order to book yourself into a suitable travel clinic.
Summary
The risk of typhoid should not be taken lightly, if you are travelling to a region with poorer sanitation and water infrastructure. Ascertaining whether or not this disease could impact your health is one of the steps to take during your pre-travel planning phase. This process is made very simple through Pinpoint Travel Health, so take advantage of the service today.
[1] https://patient.info/travel-and-vaccinations/typhoid-and-paratyphoid-fever-leaflet