Review Article DOI: 10.18231/2455-1732.2017.0014 Santosh University Journal of Health Sciences 2017;3(2):45-47 45 Epidemiology of typhoid and it’s vaccination therapy N. K. Mishra HOD, Dept. of Pharmacology, Mother Teresa Pharmacy College, Sankethika Nagar, Kothuru, Sathupally, India *Corresponding Author: Email: montu.mph@gmail.com Abstract Typhoid (enteric) fever caused by Salmonella enterica serovar Typhi (S. Typhi) is an important cause of morbidity and mortality globally. The burden of typhoid fever shows substantial variation within as well as between countries. Commonly identified risk- factors include a lack of clean drinking water, poor sanitation, inadequate hygiene practices and low socio-economic status. The incubation period is 1 to 14 days. Symptoms include: high fever, rash, weakness, constipation or diarrhoea, abdominal pain, vomiting, headaches, poor appetite. Antibiotic resistance is the major problem in order to treat effectively. The development of potent vaccine candidate for typhoid fever is a need of the hour. The prevention is made through Vi-polysaccharide conjugate typhoid vaccine and Ty21 (live typhoid) vaccination. Further supportive measures like appropriate food handling, washing hands with soap before preparing or eating food, proper sanitation contributes to reducing the risk of transmission. Keywords: Conjugate typhoid vaccine, High fever, S. Typhi, Ty21. Introduction Typhoid (typhoid fever) is a serious disease. It is caused by bacteria called Salmonella typhi also known as Salmonella enterica serotype Typhi. It causes a high fever, fatigue, weakness, stomach pains, headache, loss of appetite, and sometimes a rash. It can kill up to 30% of people who get it, if it is not treated. The bacterium that causes typhoid fever may be spread through poor hygiene habits and public sanitation conditions, and sometimes also by flying insects feeding on faeces. Public health education campaigns encouraging people to wash their hands after defecating and before handling food are an important component in controlling spread of the disease. The chlorination of drinking water has led to dramatic decreases in the transmission of typhoid fever in the United States. To help decrease rates of typhoid fever in developing nations, the World Health Organization (WHO) endorsed the use of a vaccination program starting in 1999. Antibiotic resistance is a challenge for effective treatment of typhoid and is likely to become increasingly problematic with the spread of multi-drug resistant strains. (1) Vaccinations have proven to be a great way at controlling outbreaks in high incidence areas. Epidemiology From estimation 21.7 million illnesses and 217,000 deaths are found in 2000 occurred worldwide. (2) Most often children and young adults between 5 and 19 years old are affected. Infants, children, and adolescents in south-central and Southeast Asia experience the greatest burden of illness. The developing nations, such as those found in parts of Asia and Africa, have the highest rates of typhoid fever (Fig.1). These areas have a lack of access to clean water, proper sanfiitation systems, and proper health care facilities. For these areas, such access to basic public health needs is not in the near future. (3) Fig. 1: Geographic range of typhoid fever ♦ Strongly endemic, ♦ Endemic ♦ Sporadic cases. (4) Incidence and burden of disease in India The annual mortality rate per 100,000 people from typhoid fever in India has decreased by 28.7% since 1990, an average of 1.2% a year. There have been two large-scale studies in India on the incidence of blood culture confirmed typhoid fever, one among individuals under 40 years old (5) and another among children 6 to 17 years old. (6) Transmission The pathogenic transmissions in humans are broadly divided into two groups. The first, enteric fever, is transmitted by contaminated water or food, and is caused mainly by Salmonella enterica serovar Typhi (typhoid fever) or Salmonella enterica serovar Paratyphi A, B or C (paratyphoid fever). The second one, a range of clinical syndromes including diarrhoeal disease, is caused by a large number of nontyphoidal Salmonella serovars (NTS). Clinical signs and symptoms