Typhoid (typhoid fever) is a serious disease caused by bacteria called Salmonella Typhi. Typhoid fever is a bacterial infection that has become rare in industrialised countries, but that is still common in countries with poor hygiene where it is responsible for 600,000 cases each year. Typhoid causes a high fever, fatigue, weakness, stomach pains, headache, loss of appetite, and sometimes a rash. If it is not treated, it can kill up to 30% of people who get it.

How Typhoid is transmitted

Typhoid is one of the most common communicable diseases in India. It is caused and spread by eating or drinking contaminated food or water. Since the bacterium is present in the intestine and bloodstream of infected people which passes through urine and faeces, the infection can occur in any country but it more commonly occurs in places or countries with poor personal or public hygiene. The infection is usually spread when sewage water gets mixed with drinking water and it is consumed or when an individual consumes any food or water handled by an infected person.

Some people who get typhoid become “carriers,” who can spread the disease to others.

Symptoms

It usually takes 1 to 3 weeks’ time for patients to develop typhoid symptoms after exposure to the bacteria. The duration of the disease is 3 to 4 weeks depending upon the severity of the disease (mild or severe).

• Following a 7 to 14 day incubation period, typical signs, including headaches, abdominal pain, poor appetite, possibly high fever, and very often diarrhea, progressively appears.
• Daytime drowsiness and nighttime insomnia are characteristic signs.

Available Brand names for Typhoid vaccine

Both Vi-PS conjugate and Vi-PS (polysaccharide) vaccines are available.

Currently, two typhoid conjugate vaccines, Typbar-TCV® and PedaTyph® are available in Indian market.

Vaccination Schedule & Recommended Doses of Typhoid vaccine

• Minimum ages:

• Vi-PS conjugate (Typbar-TCV® ): 6 months, Vi-PS conjugate (Pedatyph®): 6 months;
• Vi-PS (polysaccharide) vaccines: 2 years

• Typhoid conjugate vaccines (Vi-PS):
  • Typbar-TCV®: Single dose at 9-12 through 23 months followed by a booster at 2 years of age
  • Pedatyph® : Single dose at 9-12 through 23 months followed by a booster at 2 years of age
• Vi-PS (polysaccharide) vaccines: Single dose at 2 years, revaccination every 3 years.

Special precautions required before receiving Typhoid vaccine under following circumstances

• Children with an illness with high temperature (fever). It is best to wait until the illness has subsided before being immunised.
• When children are too young to be vaccinated, very careful attention to food and water hygiene is essential if they resides in at-risk area.
• Anyone who has had a severe reaction to a previous dose of this vaccine should not get another dose.
• Anyone who has a severe allergy to any component of this vaccine should not get it. Tell your doctor if you have any severe allergies.

Possible Side Effects of Typhoid vaccine

Mild pain or fever may occur. Paracetamol syrup may be given as recommended. Serious problems from typhoid vaccine are very rare.

There are things that parents can do before, during and after vaccine visits to make them easier and less stressful.

Before the Visit

• Make the vaccination appointment.
• Read any vaccine materials you received from your child’s health care professional. Learn more about the benefits & side effects of Typhoid vaccine.

• Take your child’s personal immunisation record to your appointment.

• Get enough food and pacifiers for the baby so that they remain diverted throughout the session.

• Get to the vaccination appointment on time and stay calm.

During the vaccination

• Hold your child firmly on your lap whenever possible during the vaccination.
• Distract your child by cuddling them and engaging them in their favorite toys.

Post Vaccination

• Your child should be observed for an allergic reaction for 15 to 20 minutes after receiving immunization(s).
• Cuddle and comfort your child.
• Review any information your doctor gives you about the shots, especially the Vaccine Information Statements that outline which side effects might be expected after Typhoid vaccination.
• Mild fever and soreness in the area where shot was given is common. Check with your doctor to see if you can give Paracetamol for pain or fever and their appropriate dose.
• An interval of at least 4 weeks with the MMR vaccine should be maintained while administering Typbar-TCV® and PedaTyph® vaccines.
• Typhoid revaccination every 3 years, if Vi-polysaccharide vaccine is used.

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