Prevention

Safe drinking water, improved sanitation and adequate medical care can help prevent and control typhoid fever. Unfortunately, in many developing nations, these may be difficult to achieve. For this reason, some experts believe that vaccines are the best way to control typhoid fever.

A vaccine is recommended if you live in or are traveling to areas where the risk of getting typhoid fever is high.

Vaccines

Two vaccines are available.

• One is given as a single shot at least one week before travel.
• One is given orally in four capsules, with one capsule to be taken every other day.

Neither vaccine is 100% effective. Both require repeat immunizations because their effectiveness wears off over time.

Because the vaccine won't provide complete protection, follow these guidelines when traveling to high-risk areas:

• Wash your hands. Frequent hand-washing in hot, soapy water is the best way to control infection. Wash before eating or preparing food and after using the toilet. Carry an alcohol-based hand sanitizer for times when water isn't available.

• Avoid drinking untreated water. Contaminated drinking water is a particular problem in areas where typhoid fever is endemic. For that reason, drink only bottled water or canned or bottled carbonated beverages, wine and beer. Carbonated bottled water is safer than non-carbonated bottled water.

  Ask for drinks without ice. Use bottled water to brush your teeth, and try not to swallow water in the shower.

• Avoid raw fruits and vegetables. Because raw produce may have been washed in contaminated water, avoid fruits and vegetables that you can't peel, especially lettuce. To be absolutely safe, you may want to avoid raw foods entirely.
• Choose hot foods. Avoid food that's stored or served at room temperature. Steaming hot foods are best. And although there's no guarantee that meals served at the finest restaurants are safe, it's best to avoid food from street vendors — it's more likely to be infected.
• Know where the doctors are. Find out in advance about medical care in the areas you'll visit, and carry a list of the names, addresses and phone numbers of recommended doctors.

Prevent infecting others

If you're recovering from typhoid fever, these measures can help keep others safe:

• Take your antibiotics. Follow your doctor's instructions for taking your antibiotics, and be sure to finish the entire prescription.
• Wash your hands often. This is the single most important thing you can do to keep from spreading the infection to others. Use hot, soapy water and scrub thoroughly for at least 30 seconds, especially before eating and after using the toilet.
• Avoid handling food. Avoid preparing food for others until your doctor says you're no longer contagious. If you work in the food service industry or a health care facility, you won't be allowed to return to work until tests show that you're no longer shedding typhoid bacteria.