Typhoid fever

12 May 2020 | Q&A

Typhoid fever is a life-threatening infection caused by the bacterium Salmonella Typhi.

It is usually spread through contaminated food or water.

Symptoms include prolonged fever, fatigue, headache, nausea, abdominal pain, and constipation or diarrhoea. Some patients may have a rash. Severe cases may lead to serious complications or even death.

Typhoid fever can be treated with antibiotics although increasing resistance to different types of antibiotics is making treatment more complicated.

Even when the symptoms go away, people may still be carrying typhoid bacteria, meaning they can spread it to others through their faeces.

An estimated 11–21 million people get sick from typhoid and between 128 000 and 161 000 people die from it every year. Communities lacking access to safe drinking water and adequate sanitation, and vulnerable groups including children are at highest risk.

 

Typhoid fever is common in places with poor sanitation and a lack of safe drinking water. Access to safe water and adequate sanitation, health education, appropriate hygiene among food handlers, and typhoid vaccination are all effective strategies for prevention and control of typhoid.

Vaccines have been used for many years to prevent typhoid; currently available vaccines include:

  • a newer injectable typhoid conjugate vaccine, consisting of the Vi antigen linked to tetanus toxoid protein, for children and adults from 6 months up to 45 years of age
  • an injectable vaccine based on the purified antigen for people over 2 years of age
  • a live attenuated oral vaccine in capsule formulation for people over 6 years of age.

In December 2017, WHO prequalified the first typhoid conjugate vaccine. This newer vaccine has longer-lasting immunity than older vaccines, requires fewer doses, and can be given to children from the age of 6 months.

This vaccine is currently being introduced into routine immunization in affected countries, with priority for countries with the highest burden of typhoid disease or high levels of antimicrobial resistance. With good levels of coverage, it is expected that this vaccine will help reduce the frequent use of antibiotics for typhoid treatment, which will slow the increase in antibiotic resistance in Salmonella Typhi.