Typhoid

[mainer]

We went to a specialty travel clinic this morning, and the Doctor recommended that we get typhoid vaccines.

Malaria was not even brought up as an issue.

One of my kids is allergic to the antibiotics used to treat typhoid, so we thought we may use the vaccine.

Anyone there know about the risk of typhoid in the DR?

Mainer

[Ken]

Good thing I read this board, otherwise I wouldn't know all the things that I should be worrying about.

[mainer]

So Ken,
I take it that typhoid is not a big deal there????

[Ken]

Not so far as I know. I have never heard anything about typhoid during my years here. But then, I have never spent any time in the frontier area near border with Haiti. Possibly there is a problem there that I haven't heard about.

[Porfio_Rubirosa]

People in resorts don't catch malaria, typhoid, or anything else except, maybe, Trujillo's revenge. And then only if they're not careful.

I don't know anyone who has come down with Malaria. I do know people who have caught Typhoid. It can happen in poor urban or rural areas. Again, no threat on the resort.

[mainer]

Thanks, Porfio

I think we will go for it, especially for the one allergic to antibiotics.
We are not planning to stay at resorts. We are hoping to travel and look around.


Mainer

[Keith R]

Mainer,
It's a pretty standard recommendation by developed nation MDs to travellers headed to developing nations to recommend a tetanus booster, typhoid vaccine, Hib & gamma globulin (if you're not up-to-date on these) -- just as a general precaution, not because of risk specific to the country you're visiting. But really, you are at little to no risk from typhoid in the DR (or anywhere else for that matter) as long as you're careful about things like poorly prepared street food. Check out what the World Health Organization (WHO) has to say on the matter, copied below. I've also provided the link to the WHO page on the subject
Enjoy the trip!
Best regards,
Keith

>>Transmission: Infection is transmitted by consumption of contaminated food or water. Occasionally direct faecal?oral transmission may occur. Shellfish taken from sewage-polluted beds are an important source of infection. Infection occurs through eating fruit and vegetables fertilized by night soil and eaten raw, and milk and milk products that have been contaminated by those in contact with them. Flies may transfer infection to foods, resulting in contamination that may be sufficient to cause human infection. Pollution of water sources may produce epidemics of typhoid fever, when large numbers of people use the same source of drinking-water.
>>
>>Geographical distribution: Worldwide. The disease occurs most commonly in association with poor standards of hygiene in food preparation and handling and where sanitary disposal of sewage is lacking.
>>
>>Risk for travellers: Generally low risk for travellers, except in parts of north and west Africa, in south Asia and in Peru. Elsewhere, travellers are usually at risk only when exposed to low standards of hygiene with respect to food handling, control of drinking-water quality, and sewage disposal.
>>
>>Prophylaxis: Vaccination.
>>
>>Precautions: Observe all precautions against exposure to foodborne and waterborne infections


WHO fact sheet on typhoid

[MommC]

of typhoid fever, typhus (not sure of the difference between the two) and cholera in the poorer barrios of Santo Domingo in particular. Usually due to unsanitary conditions and also after major events such as hurricanes.
I'd take the precaution of having the child allergic to antibiotics vacinated although you may not want to bother for the rest of the group. There has been a minor outbreak in the past 18 months or so of polio also and when I was there over the winter there was a push on to do vaccinations at all the local/rural clinics.
Make sure your tetanus shots are also up to date!

[Jane J.]

People in resorts could catch Typhoid, Porfio. Where there is salmonella, there is typhoid too, and you can contract either through food or water; especially unpasteurized milk and raw seafood. It is not contagious - not an airborne illness.

Mainer, I would definitely vaccinate a child who's allergic to the treatment, as Typhoid can recur after treatment as well.

[Keith R]

Porfio,
Technically speaking, people in resorts can catch malaria. Malaria ia transmitted by mosquito (the same one that also transmit dengue), and the mosquito does not respect human boundaries -- it does not care if you're in a resort or a batey. During late 1999-early 2000 there was a malaria alert in Altagracia Province (check the archives -- it was discussed then), the same province that contains Punta Cana. In fact, if I recall, the German health services started recommending malaria prophylaxis for tourists headed to Punta Cana, as a precaution, since a German tourist had reportedly developed malaria after visiting there.
Presently there is no malaria alert I can find for the DR, so it's not a known problem at present. But that doesn't mean it hasn't happened before or that it couldn't happen again.
Regards,
Keith