Typhoid Vaccination for International Travel

Typhoid fever, or typhoid, is an acute illness infecting 9.2 million people worldwide each year, according to the Centers for Disease Control and Prevention (CDC). In the U.S., the CDC reports more than 5,700 cases of typhoid each year. In most cases, travelers caught the infection while abroad.

The Salmonella Typhi bacteria causes typhoid. It spreads through contaminated food or water. Humans are the only hosts of the bacteria. It spreads through feces for six weeks to three months after infection. The most common symptoms include fever, anorexia, abdominal discomfort, and headaches.

Typhoid can be fatal in up to 10% of reported cases. The number of drug-resistant strains of Salmonella Typhi has increased since 1989. Drug resistance is spreading due to overcrowding, poor sanitation, and increased travel.

The symptoms of typhoid can vary. They usually include:

• High fever
• Weakness and fatigue
• Abdominal pain
• Headache
• Loss of appetite
• Diarrhea or constipation
• Rash (flat, rose-colored spots)
• Muscle aches
• Chills
• Sweating
• Confusion or delirium (in severe cases)

How long typhoid infection lasts can vary. Treatment and severity can increase or decrease average times. Typically, infection lasts for three to four weeks. But, with antibiotics, symptoms generally improve within one to two weeks.

If you are prescribed antibiotics for typhoid, be sure to complete your full course. This helps ensure complete recovery and can reduce the risks of drug-resistant typhoid developing.

The rash associated with typhoid fever is often referred to as “rose spots.” These spots are small, flat, and rose-colored. They appear on the abdomen and chest. The spots typically measure about 1/8 inch (3 mm) in diameter and may appear in groups. The rash usually develops during the first week of the illness and can last for two to five days before fading.

Typhoid usually occurs in areas with poor sanitation and limited access to clean water. It is most common in parts of Asia, Africa, Latin America, the Caribbean and the Middle East. The highest risk areas include Africa, South Asia, and parts of Central and South America. For a full list of higher risk countries, see below:

• Afghanistan
• Algeria
• Angola
• Armenia
• Azerbaijan
• Bahrain
• Bangladesh
• Benin
• Bhutan
• Bolivia
• Botswana
• Brazil
• Brunei
• Burkina Faso
• Burundi
• Cambodia
• Cameroon
• Cape Verde
• Central African Republic
• Chad
• China
• Colombia
• Comoros
• Costa Rica
• Cote d’Ivoire
• Democratic Republic of the Congo
• Djibouti
• Dominican Republic
• East Timor
• Egypt
• El Salvador
• Equatorial Guinea
• Eritrea
• Eswatini
• Ethiopia
• French Guiana
• Gabon
• Gambia
• Georgia
• Ghana
• Guatemala
• Guinea
• Guinea-Bissau
• Guyana
• Haiti
• Honduras
• Hong Kong
• India
• Indonesia
• Iran
• Iraq
• Israel
• Jordan
• Kenya
• Kuwait
• Laos
• Lebanon
• Lesotho
• Liberia
• Libya
• Macao
• Madagascar
• Malawi
• Malaysia
• Maldives
• Mali
• Mauritania
• Mexico
• Morocco
• Mozambique
• Myanmar
• Namibia
• Nepal
• Nicaragua
• Niger
• Nigeria
• North Korea
• Oman
• Pakistan
• Palestinian Territories
• Papua New Guinea
• Peru
• Philippines
• Qatar
• Republic of the Congo
• Rwanda
• Sao Tome and Principe
• Saudi Arabia
• Senegal
• Sierra Leone
• Singapore
• Somalia
• South Africa
• South Sudan
• Sri Lanka
• Sudan
• Suriname
• Syria
• Tahiti
• Taiwan
• Tanzania
• Thailand
• Togo
• Trinidad and Tobago
• Tunisia
• Türkiye
• Turkmenistan
• Uganda
• United Arab Emirates
• Venezuela
• Vietnam
• Western Sahara
• Yemen
• Zambia
• Zimbabwe

Travelers to these regions are at risk of contracting typhoid fever. Those visiting smaller cities, rural areas or staying with locals are at an increased risk.

Typhoid is spread through contaminated water and food or through person-to-person contact. Those infected with typhoid can spread the disease through their stool. If you eat food or drink touched by a person with typhoid, you may contract the infection.

Some food or drinking water may also become contaminated with the typhoid bacteria. The CDC recommends rinsing any fruits or vegetables before eating them. Also, be sure to avoid drinking water or using ice from unknown sources. The best form of protection is vaccination.

Yes, typhoid fever can be cured completely with proper treatment. Early diagnosis and fast treatment with antibiotics can lead to a full recovery. It’s important to complete the entire course of antibiotics to ensure a full recovery.

Supportive care such as hydration and rest is crucial for recovery. In some cases, complications can occur, but with proper medical care, these can often be managed effectively.

The typhoid vaccine, or typhoid shot, is designed to prevent typhoid infection. There are two main types of typhoid vaccines:

• Typhoid Vaccine Live Oral Ty21a : Also known as “typhoid pills,” the vaccine is made from attenuated live bacteria. It provides up to five years of protection and is approved for use in individuals over six years old. The patient takes the pills over four doses. Due to ongoing supply limitations, the oral typhoid vaccine may not be available at all Passport Health locations.
• Typhoid Vaccine (Injectable) : Made from inactive bacteria, the injectable typhoid vaccine provides protection for up to two years. It is approved for use in individuals over two years old.

According to the CDC, the risks associated with both vaccines are low. Side effects and allergic reactions are relatively rare and generally mild.

While not required, typhoid vaccination is recommended for travel to most countries. Travelers to areas with outbreaks or poor sanitation are at higher risk.

Drug-resistant typhoid is present in large portions of Asia and Africa. Vaccination is highly recommended for travel to these regions. Antibiotics are less likely to be effective against drug-resistant typhoid. Those with a weakened immune system should also receive the vaccine.

For destination advice and to learn about available typhoid vaccines, visit your nearest Passport Health clinic.

No, a prescription is not required to get a typhoid vaccine from Passport Health.

Passport Health collaborates with experienced nurses and doctors to deliver efficient travel healthcare. We provide the typhoid vaccine and other essential immunizations directly to you.

If you are at increased risk or have health concerns, consult your PCP before getting the vaccine.

Travelers should get the typhoid vaccine at least one week before travel. This allows time for the vaccine to work before entering a region with typhoid.

Planning a trip? Schedule an appointment with Passport Health to ensure you’re protected.

The cost of the typhoid vaccine can vary. At Passport Health, we offer both types of typhoid vaccines, and we aim to keep our prices competitive.

For specific pricing, contact your nearest Passport Health clinic. Our team provides detailed information to help you understand your options.

Typhoid vaccines last between two and five years, depending on the type of vaccine. Oral typhoid vaccines provide five years of protection. Injectable vaccines offer two years of protection. Be sure to speak with a travel health specialist about which vaccine is right for you.

Both typhoid vaccines, oral and injectable, don’t provide lifetime protection. So, a booster dose is recommended. Those who got the injectable typhoid vaccine need re-vaccination after two years. Individuals who used the oral vaccine would need to be re-vaccinated after five years.

If you have received a typhoid immunization before but are unsure of your level of protection, contact your local Passport Health by calling or schedule your appointment online now.

Passport Health offers typhoid vaccinations throughout the US. Meet with a travel health specialist today to discuss your trip and vaccine options.