Description: Typhoid fever is an acute, life-threatening febrile illness caused by the bacterium Salmonella enterica Typhi.
Occurence: An estimated 16 million cases of typhoid fever and 600,000 related deaths occur worldwide each year. Approximately 2.6 cases of typhoid fever were reported to the Centers for Disease Control and Prevention per 1 million U.S. citizens and residents traveling abroad during the period 1992–1994.
Risks for Travelers: Typhoid vaccination is not required for international travel, but it is recommended for travelers to areas where there is a recognized risk of exposure to S. Typhi. Risk is greatest for travelers to the Indian subcontinent and other low-income countries (in Asia, Africa, and Central and South America) who will have prolonged exposure to potentially contaminated food and drink. Vaccination is particularly recommended for those who will be traveling in smaller cities, villages, and rural areas off the usual tourist itineraries. Travelers should be cautioned that typhoid vaccination is not 100% effective and is not a substitute for careful selection of food and drink.
Clinical Presentation: The hallmark of infection is persistent, high fevers. Other common symptoms and signs include headache, malaise, anorexia, splenomegaly, and relative bradycardia. Many mild and atypical infections occur.
Prevention: Vaccine: Two typhoid vaccines are currently available for use in the United States: an oral, live, attenuated vaccine (Vivotif Berna vaccine, manufactured from the Ty21a strain of S. Typhi by the Swiss Serum and Vaccine Institute) and a Vi capsular polysaccharide vaccine (ViCPS) (Typhim Vi, manufactured by Aventis Pasteur) for intramuscular use. Both vaccines have been shown to protect 50%–80% of recipients.
source: CDC Typhoid Health Information