Limitations of typhoid vaccination for travellers

Around one-third of travellers to endemic areas receive pre-travel typhoid vaccination, increasingly with the new parenteral vaccination Typhim Vi (Mérieux). More than 200 cases of Salmonella typhi and S. paratyphi infection are imported into the UK each year. Despite the widespread use of immunisation, non-specialist clinicians and the travelling public do not appear to fully appreciate the limitations of currently available vaccination. These limitations are not adequately highlighted in either the Green Book of Immunisation against Infectious Diseases (HMSO, 1992) or the new handbook Health Information for Overseas Travel (HMSO, 1995) which are important sources of reference for clinicians and practice nurses. This may delay consideration of diagnosis and presentation for treatment in immunised travellers.