Monday, July 11th, 2011

Are You Vaccinated Against Typhoid

typhoid vaccineThis is high season for all water and food borne diseases. One of the most dangerous food and water borne infections is typhoid, caused by the bacteria called ‘Salmonella typhi’. It travels through faecal contamination of food or water. About 3%-5% of patients become carriers of the bacteria after the acute illness. Some patients suffer a very mild illness that goes unrecognized. These patients can become long-term carriers of the bacteria. The germ multiplies in the gallbladder, or liver and passes into the bowel. The chronic carriers can be the source of new outbreaks of typhoid fever for many years.

 

Symptoms
Typhoid fever may cause:
• Fever (in step ladder form)
• Coated tongue (white colour)
• Headache
• Pain in the abdomen because of enlarged spleen
• Diarrhoea or constipation
• Rashes over the body
• Extreme exhaustion

Typhoid vaccines

Currently two types of typhoid vaccines are available——“Vi antigen”, derived from polysaccharide capsule and the other one, “Ty21a” is in the form of enteric-coated capsules for oral use.

• ‘Vi antigen’ vaccine: It is an inactivated vaccine available as injectable form. ‘Vi antigen’ vaccine is given either on thigh or arm. It requires a single dose and can be administered only after the age of two years. Revaccination is required in every 2 years. The cost of this vaccine varies from Rs.100/- to 300/- per injection. The protection rate is 70%-80%.

• Oral ‘ty21a’ vaccine: It is a weakened form of the live bacteria and three doses are required to be given on alternate days. It can be given to children over 6 years of age and above because younger children cannot swallow the large capsules of the vaccine. The capsules should be swallowed intact & not opened or chewed. Revaccination is required in every 5 years. Its cost is Rs.275/- for a pack of three. The protection rate of this vaccine is 67%-82%.

The vaccines are almost equally effective and require revaccination every 3-5 years. However, it is difficult to suggest, how long should revaccination continue. In all probability, vaccination should continue till the patient needs protection from the disease.

Who should get vaccinated

Typhoid is a common disease in India with estimated incidence of 5 million cases per annum. The currently available vaccines are safe and efficacious. It must be given to all food handlers, travellers to endemic areas, those who eat outside open food frequently. It should also be given to those who have suffered typhoid fever as typhoid does not lead to protective immunity recurrences are known to occur. In such cases, it is given 6 weeks after complete recovery from typhoid fever.

Both the “Ty21a” and “Vi antigen” vaccines can cause headache and fever, but do not cause serious side effects.

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