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Typhoid
fever is a life-threatening illness caused by the bacteria Salmonella Typhi.
The bacteria spreads through contaminated food or water. An infected person can
spread typhoid fever to others through their feces (poop). If a person with
typhoid fever prepares food without washing their hands properly, the bacteria
can get into the food and spread to people who eat it. Contaminated water used
for drinking or cooking can also spread typhoid fever if the water contains
Salmonella Typhi bacteria from the feces of an infected person. Typhoid fever
is still common in many parts of the world where there is limited access to clean
drinking water and proper sanitation. In large cities and more developed areas,
typhoid fever can spread when municipal water systems become contaminated.
Symptoms and Effects of Typhoid Fever
The symptoms of typhoid fever include sustained high fevers as high as 103-104
degrees Fahrenheit, weakness, stomach pains, headache, and loss of appetite.
The illness lasts 2-4 weeks if left untreated. It is estimated that typhoid
fever results in approximately 11-20 million illnesses and more than 128,000 deaths
worldwide each year. Children under the age of 2 are at the highest risk of
developing severe illness or complications from typhoid fever. Complications
include intestinal bleeding and perforation (a hole forming in the intestines),
which can be fatal if not treated quickly with appropriate antibiotics. Even
after recovery from typhoid fever, bacteria may still be present in the stool
and urine and the person can shed the bacteria for up to 3 months. This means
they may still spread the infection to others during this time if proper
handwashing does not occur.
Development and Types of Typhoid Fever
Vaccines
There are two main types of typhoid vaccines available: live, attenuated oral
vaccines and injectable vaccines. Both types of typhoid vaccines provide
immunity against different strains of the bacteria. Vaccination is recommended
for travelers to regions where typhoid fever is common as well as for children
over the age of 2 living in endemic areas. The first typhoid vaccine introduced
was the live Ty21a oral vaccine. This vaccine was developed in the 1970s and
contains a weakened but still living form of the Salmonella Typhi bacteria. It
requires taking four capsules over a period of days to provide protection. The
Ty21a oral vaccine is at least 50% effective and immunity lasts for 3-5 years.
The other option is an injectable inactivated polysaccharide vaccine known as
Typhim Vi. This vaccine contains killed Salmonella Typhi bacteria. It provides
>80% protection against typhoid fever when given as a single dose. Immunity
from the injectable Typhim Vi vaccine is thought to last up to 3 years. Both
typhoid vaccines were designed to provide single-dose protection against
typhoid fever. However, for areas where typhoid is common and risk of exposure
is high, the World Health Organization now recommends a booster dose every 3
years or 2 doses at least 3 weeks apart for sustained protection.
Vaccines and Public Health Policy
While vaccines are effective, uptake and immunity levels in populations need to
be high enough to disrupt disease transmission in order to eliminate typhoid as
a public health problem. Mass immunization campaigns aimed at children are
being implemented in some typhoid endemic countries. For example, in 2008
Bangladesh launched an ambitious program to vaccinate 32 million children ages
1-15 with the oral Ty21a vaccine. This public health intervention significantly
reduced the national burden of typhoid fever within a few years. Similar
programs have been successful in parts of India, Indonesia, and Africa.
International organizations like the WHO and UNICEF support vaccination
programs in developing nations. Strategic use of typhoid vaccines, coupled with
improved water, sanitation, and hygiene infrastructure projects, is key to
typhoid elimination globally in the long run. Typhoid
Fever Vaccines policies need to take into account the type of vaccine
used, effectiveness duration, risk groups targeted, cost effectiveness, and
integration with other public health interventions. Ongoing surveillance is
also important for monitoring impact and guiding vaccination policies.
Challenges With Typhoid Vaccine Access
and Delivery
Despite effectiveness, several challenges still hinder widespread use of
typhoid vaccines where they are needed most. Cost remains an obstacle, as both
injectable and oral typhoid vaccines usually have to be purchased with national
health budgets that have many competing priorities in developing nations.
Cold-chain storage and distribution of the oral Ty21a vaccine poses logistical
difficulties in remote rural areas lacking reliable refrigeration. Social
acceptance of new vaccines also influences uptake. Lack of awareness about
typhoid fever as a public health issue in some communities has hampered
education efforts. Further research is being done to develop more heat-stable,
single-dose alternatives to simplify delivery. Lower-cost combination typhoid
and hepatitis A vaccines show promise. International support will continue to
be crucial for increasing typhoid vaccine access so that one day this
preventable disease can be eradicated globally through coordinated vaccination
programs and improvements to water and sanitation infrastructure.
In conclusion, Typhoid Fever Vaccines remains an important public health issue
in developing nations. While antibiotics can treat the illness, vaccination is
a cost-effective method to prevent typhoid fever from occurring. Both live oral
and injectable typhoid vaccines have been developed and offer protection when
administered according to recommended guidelines. Strategic mass immunization
can significantly reduce disease in communities and countries over time if
vaccination programs achieve sufficiently high coverage levels. International
policies aim to expand access to typhoid vaccines, especially in endemic
regions lacking safe water and basic sanitation. Continued efforts are still
needed to address barriers hindering wider.
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