Typhoid

Fecal-oral route through contaminated food and water. Caused by Salmonella typhi bacteria.

Symptoms

Sustained fever, headache, abdominal pain, constipation or diarrhea, rose-colored spots on the chest. Gradual onset over 1–3 weeks.

Treatment

Antibiotics (azithromycin, fluoroquinolones, or ceftriaxone depending on resistance patterns). Increasing antimicrobial resistance is a concern.

Endemic regions

South/Southeast Asia (highest risk), Africa, Latin America. Risk correlates with sanitation infrastructure.

Prevention & prophylaxis

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Injectable Vi polysaccharide (Typhim Vi)

Single intramuscular dose, ≥2 weeks before travel. ~55–72% effective. Booster every 2 years if continued exposure. For adults and children ≥2 years.

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Oral Ty21a (Vivotif)

4 capsules taken every other day, completed ≥1 week before travel. ~50–80% effective. Booster every 5 years. Must be refrigerated. Not for children <6 or immunocompromised individuals. Avoid antibiotics during course.

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Food and water hygiene

Drink only bottled or boiled water. Avoid ice in drinks. Eat only thoroughly cooked foods served hot. Avoid raw vegetables, salads, and unpeeled fruits. Frequent handwashing with soap.