CDC Alert - Level 2, Practice Enhanced Precautions

Typhoid Fever Travel Alert Level 2 Issued by CDC

Typhim Vi and Vivotif are typhoid vaccines approved by the FDA
sign entering pakistan
Pakistan (Vax Before Travel)

A new international Level 2 Travel Alert has been issued by the Centers for Disease Control and Prevention (CDC) for typhoid fever in Pakistan.

Typhoid fever is a severe disease caused by the Gram-negative bacterium Salmonella enterica serovar Typhi. Antibiotic-resistant S.

On June 27, 2018, the CDC said there is an ongoing outbreak of extensively drug-resistant (XDR) typhoid fever in Pakistan.

Moreover, this XDR strain does not respond to most antibiotics.

This means all travelers to Pakistan are at risk of contracting XDR typhoid fever and should take precautions to protect themselves, including getting a typhoid fever vaccination.

During 2018, cases of XDR have been reported in the United States among travelers returning from Pakistan.

Approximately 85 percent of typhoid fever and 90 percent of paratyphoid fever cases in the United States are among international travelers, reports the CDC. 

On a worldwide basis, an estimated 26 million cases of typhoid fever and 5 million cases of paratyphoid fever occur worldwide each year, causing 215,000 deaths.

In the USA, approximately 300 culture-confirmed cases of typhoid fever and 80 cases of paratyphoid fever caused by S. enterica serotype Paratyphi A are reported each year.

Two typhoid vaccines are available in the United States:

  • Vi capsular polysaccharide vaccine (ViCPS) (Typhim Vi, manufactured by Sanofi Pasteur) for intramuscular use
  • Oral live attenuated vaccine (Vivotif, manufactured from the Ty21a strain of serotype Typhi by PaxVax)

Both typhoid vaccines only protect 50–80 percent of recipients. And, these typhoid vaccines do not offer protection against paratyphoid fever.

This Level 2 Travel Alert means Americans traveling to Pakistan should speak with a healthcare provider regarding their immunization status, before departing on an international trip.

International travelers can easily request a vaccination appointment with a pharmacy at Vax-Before-Travel.

The CDC Vaccine Price List provides the private sector vaccine prices for general information, and vaccine discounts can be found here.

Vaccines, like any medicine, can have side effects, says the CDC. You are encouraged to report negative side effects of vaccines to the FDA or CDC.