Vaccines for preventing typhoid fever

Ty21a and Vi polysaccharide vaccines are effective in reducing typhoid fever; new vaccines are promising

Elspeth Anwar1, Elad Goldberg2, Abigail Fraser3, Camilo J Acosta4, Mical Paul5, Leonard Leibovici2

Liverpool School of Tropical Medicine, Department of Clinical Sciences, Liverpool, UK
Beilinson Hospital, Rabin Medical Center, Department of Medicine E, Petah Tikva, Israel 
University of Bristol, Oakfield House, MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK 
Merck Global Health Outcomes Vaccines, West Point, PA, USA
Rambam Health Care Center, Haifa, Israel and Sackler Faculty of Medicine, Unit of Infectious Diseases, Tel Aviv, Israel

Vaccines for preventing typhoid fever. Cochrane Database of Systematic Reviews 2014, Issue 1. Art. No.: CD001261.

To read the full review please follow this link: DOI: 10.1002/14651858.CD001261.pub3.

Typhoid fever is a bacterial infection found mainly among children and adolescents in south and east Asia, Africa, Latin America and the Caribbean. Typhoid fever is spread by food, drink, or contaminated water. It is characterized by fever, abdominal symptoms, headache, loss of appetite, cough, weakness, sore throat, dizziness and muscle pains. The infection also sometimes causes psychosis and confusion. Mortality varies and can reach 10% of cases. Treatment normally consists of antibiotics, but problems with drug-resistant strains have been reported. Improved sanitation and food hygiene are important control measures. However, these are associated with socioeconomic progress that has been slow in most affected areas. Therefore vaccination is an effective way to try to prevent this disease. The review found 18 trials (17 with usable data): Six evaluated vaccine effectiveness only; six evaluated vaccine effectiveness and adverse events; and six provided data only on adverse events. The two major vaccines currently licensed for use, Ty21a and Vi polysaccharide, were effective in reducing typhoid fever; adverse events such as nausea, vomiting and fever were rare. Other vaccines, such as a new, modified, conjugated Vi vaccine called Vi-rEPA, are in development and appear promising. A vaccine that could be given to infants would be helpful as they are probably at increased risk of this infection.


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