• is a bacterial infection caused by the bacterium Salmonella enterica serotype Typhi (S. Typhi).
• it primarily affects the intestines and bloodstream.
• is a serious illness that can be fatal if not treated properly, but it is treatable with antibiotics.
• is more common in areas with poor sanitation and limited access to clean water and food.

Symptoms of Typhoid Fever

The symptoms of typhoid fever generally appear 6 to 30 days after exposure to the bacteria. They can vary in severity but commonly include:

• fever, abdominal pain or cramping, often accompanied by bloating.
• general fatigue, weakness, and malaise, loss of appetite.
• headache.
• diarrhoea or constipation.
• rash – small, flat, rose-coloured spots may appear on the skin, especially on the chest and abdomen.
• enlarged liver or spleen.
• cough – a mild cough can occur, although it is not always present.
• delirium or confusion – in severe cases.

Complications of Typhoid Fever

If left untreated, typhoid fever can lead to serious complications, including:

• intestinal perforation – a hole in the intestine, which can lead to peritonitis (infection of the abdominal cavity) and sepsis.
• internal bleeding – caused by damage to the intestines.
• sepsis – a life-threatening response to infection that can cause organ failure.
• meningitis or encephalitis – rare, but can occur in severe cases of typhoid fever.

Treatment

• Antibiotics: Typhoid fever is treatable with antibiotics, depending on the local resistance patterns of S. Typhi. Ask your doctor for a script to take with you.
• Hydration: Keeping the patient hydrated is important, especially if diarrhoea or vomiting is present.
• Supportive Care: In severe cases, hospitalisation may be required for intravenous fluids and supportive care.

Factors That Affect Risk

• Local Water Supply:
  • • In many Asian countries, even cities with good infrastructure may still have issues with local water contamination. This can affect the tap water, even in hotels that have decent standards. If the local water supply is contaminated, the risk of Typhoid transmission increases.
• Hotel Water Sources:
  • • Hotels may rely on local water sources for drinking, bathing, and cooking. While high-end hotels may filter and treat their water, the risk can still persist in some situations.
    • Some hotels may not treat water as thoroughly as others, particularly if the hotel uses local water for non-drinking purposes (e.g., in showers, bathtubs, or swimming pools).
• Ice and Food Preparation:
  • • Even in high-end hotels, ice and fresh produce might still be sourced from local water. If the water used to make ice or wash food is contaminated, it can still pose a risk, even if the hotel otherwise maintains high standards.
• Drinking Water:
  • • Hotels in many parts of Asia will provide bottled or purified water for drinking, which is typically safe to consume. However, travelers should still be cautious about drinking water from the tap, even in higher-end hotels, unless it is specifically treated or bottled.
• Hotel Hygiene Practices:
  • • Most reputable hotels follow international hygiene standards, including using purified water for their kitchen and drinking supplies. However, contamination can still occur if staff inadvertently uses contaminated water for cleaning or preparing food.

Preventive Measures:

• Drink Bottled or Filtered Water
• Avoid Ice: If you’re unsure about the source of ice, it’s best to avoid it, especially in places with known water contamination issues.
• Wash Hands: Practice good hand hygiene by washing your hands regularly with soap and water, especially before eating.
• Use Only Safe Water for Brushing Teeth: Avoid using tap water to brush your teeth; always use bottled or boiled water.

The Typhoid Vaccine:

There are two types of typhoid vaccines available:

1. Injectable Typhoid Vaccine (Typhim Vi)

• a booster dose is required every 3 years.
• is registered for use in individuals aged ≥2 years.
• a single dose of Typhim Vi confers 74% efficacy.

2. Oral Typhoid Vaccine (Vivotif)

• In Australia, the Vivotif® Oral Typhoid Vaccine (Ty21a) is recommended for individuals aged 6 years and older who are traveling to or residing in areas where typhoid fever is endemic.
• Vivotif is a live attenuated oral vaccine for typhoid fever, containing a weakened strain of Salmonella Typhi (Ty21a).

Oral Dosing Schedule:

3-Dose Schedule: One capsule on days 1, 3, and 5.

• a booster dose is required every 3 years

4-Dose Schedule (optional): One capsule on days 1, 3, 5, and 7.

• a booster dose is required every 5 years
• confers about 80% efficacy.

Can You Get Typhoid Symptoms from Vivotif?