Typhoid infections can be largely eliminated through improved water and sanitation systems, like those used in industrialized countries. However, the development of such infrastructure requires significant capital investments beyond the near-term reach of most developing countries.
Improvements in water and sanitation systems are critical, but longer-term, investments for developing countries. Likewise, food hygiene is also a critical part of preventing typhoid fever. Street vendors, restaurants, bars, and markets may unknowingly serve food or beverages that are contaminated or washed with contaminated water. Surveillance and monitoring of water borne disease outbreaks highlight the disease burden and may help stimulate investment in water and sanitation systems.
In populations where the rights of access to safe water and basic sanitation have yet to be addressed, typhoid vaccination can help reduce this gap in equity, social justice, and human rights by delivering a safe, effective and affordable intervention to control typhoid fever.
Typhoid vaccines can also provide herd immunity to unvaccinated individuals against the disease when used as part of a large-scale vaccination effort, helping to further reduce the prevalence and spread of antibiotic-resistant typhoid. Herd immunity refers to the phenomenon whereby protection spills over to individuals who have not been vaccinated. The effect has been demonstrated powerfully in relation to the use of typhoid vaccine.
Evidence from Cuba, Iran, Tajikistan, India, Thailand, Malaysia, Vietnam, and China confirms that a one-dose, ViPS vaccination strategy targeting a wide age range can effectively control disease.