Typhoid

Key Information

• Disease: Typhoid fever is caused by Salmonella enterica serovar Typhi (S. typhi), transmitted through contaminated food and water.
• Clinical Course: Ranges from mild illness to severe systemic disease; untreated, it can be fatal.
• Vaccines: Two authorized types: parenteral (Typh-I) and oral (Typh-O). Both provide approximately 50% protection.
• Protection Duration: Typh-I lasts 3 years; Typh-O lasts about 7 years.

Recommendations for Use

• Travellers: Recommended for those aged 2 years and older traveling to South Asia.
• Laboratory Personnel: Recommended for those at risk of exposure to S. typhi.
• Contacts of Carriers: Recommended for those in close contact with chronic carriers.

Vaccine Administration

• Typh-I:
  • Age: 2 years and older.
  • Dose: Single 0.5 mL dose, intramuscularly.
  • Administration: At least 14 days prior to exposure.
• Typh-O:
  • Age: 5 years and older.
  • Dose: One capsule on alternate days, total of 4 capsules.
  • Administration: Complete at least 7 days prior to exposure.

Preparations Authorized for Use in Canada

• Typh-I: TYPHIM Vi® by Sanofi Pasteur SA.
• Typh-O: Vivotif® by PaxVax Berna GmbH.

Special Populations

• Pregnancy and Breastfeeding: Typh-I can be considered if needed. Typh-O only if high risk and Typh-I not available.
• Immunocompromised Persons: Typh-I may be used; Typh-O is contraindicated.

Safety and Adverse Events

• Common Adverse Events: Injection site tenderness, fever, headache, malaise (Typh-I); abdominal pain, nausea, diarrhea (Typh-O).
• Serious Adverse Events: Rare, including anaphylaxis.