Updated Typhoid Vaccine Recommendations

The country-specific recommendations for the use of typhoid vaccine in travellers have been revised, and will be updated on both the TRAVAX and fitfortravel websites in the coming week. These recommendations take into account data on imported typhoid cases, recently published academic literature on typhoid epidemiology and international review of typhoid incidence and vaccine use.

Typhoid is most commonly spread through ingestion of food and drink that has been contaminated with faeces or urine from a human case or carrier. Travellers to all destinations should be advised to practice good Food and Water hygiene to reduce the risk of all food and water borne infections.

Our review determined that the majority of typhoid illness in travellers is acquired in Central/South Asia. Consequently TRAVAX will recommend that typhoid vaccine only be ‘usually advised’ for the following countries; Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan. For travellers to other countries where a lower risk of typhoid has been identified, vaccination may be ‘sometimes advised’ if they are:

• Venturing off the usual tourist routes to visit smaller villages, cities and rural areas where access to adequate sanitation and safe water may be limited.
• Visiting friends and relatives.
• Unable to take sufficient care with food and drink, including children.
• Those with increased susceptibility to infection or to severe outcome, i.e. travellers with achlorhydria or immunocompromise.
• Long stay travellers.

For some countries, typhoid vaccination is not recommended.

Country specific advice on the need for typhoid vaccination can be found on the individual country pages of TRAVAX and fitfortravel. Further information can be found on the Typhoid page.