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Travel Medicine (cont.)

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Typhoid fever

Typhoid fever is an infection caused by a bacterium called Salmonella typhi. Most people who get sick develop a headache, a very high fever (up to 103 F or 104 F), and fatigue. Nausea, abdominal pain, diarrhea, or constipation may also occur.

The disease spreads when infected human waste contaminates food or water or is otherwise ingested. Some people are able to carry the bacteria inside their body for a very long time ("carriers"), even after symptoms have disappeared. Carriers can get it again or spread it to other people. People who get sick may be given antibiotics by their doctor. In addition to the antibiotics, people should make sure they always wash their hands after toileting and before cooking, so that they don't spread the disease to anyone else. Some occupations require proof that you no longer carry any typhoid bacteria before you may go back to work; a doctor may perform several cultures of your stool before clearing you for work.

Typhoid fever occurs in many areas around the world, especially Asia, Africa, and South America. A vaccine is available to reduce the risk of getting typhoid, and it lasts several years. Ask a doctor or local public-health department about typhoid vaccination before you travel. Food and water precautions (see "What is safe to eat and drink while traveling?") also reduce the risk of disease. The saying "Boil it, cook it, peel it, or forget it!" helps you remember how to prevent becoming sick with typhoid fever (and many other infections) while traveling.


Polio is a viral illness that can lead to severe neuromuscular problems. Polio is spread from person to person. Infected oral secretions and feces can cause disease. Many people have no symptoms, but some have neurological problems such as weakness and paralysis. Symptoms are especially severe if they involve the breathing muscles. Some people are left with permanent neurological disabilities such as paralysis of limbs or breathing muscles.

Thanks to a global public-health campaign, many countries no longer have polio. A few countries in Africa, South Asia, Southeast Asia, and the Middle East still have outbreaks. The list of infected countries is constantly changing, as some countries successfully eliminate the infection and others become reinfected. If there is international spread from a country within 12 months, the World Health Organization (WHO) may declare a public-health emergency and issue updated vaccine requirements for travelers staying in those countries longer than four weeks. Proof of vaccination on an International Certificate of Vaccination or Prophylaxis may be required before leaving. Check the CDC web site ( for an update to see if your itinerary includes any of these countries.

The inactivated polio vaccine is recommended if the traveler is going to an area where polio is still occurring. Unless special circumstances arise as above, a single lifetime booster dose in adulthood is sufficient if the traveler has received the usual vaccine series in childhood. If the traveler has not been fully vaccinated in the past (has not received all doses at recommended times), more doses may be needed.

Medically Reviewed by a Doctor on 10/26/2016

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