Q: My 8 and 4 years old children got affected by typhoid recently, when we changed our house where the water line got mixed with sewer line. They got high fever after every four hours. They were given antibiotics Rite-o-cef for 15 days. Vaccinations for typhoid are given to them after every two years. Will typhoid affect the health of my children again? Are the germs still in the body and can reactive again? Can the vaccines completely cure the person from this disease in the period of two years?

A:Typhoid fever is a common bacterial infection in India caused by Salmonella typhi and is transmitted by the faecal-oral route, typically involving contaminated food or water, like the sewer mixed water in your children's case. It causes a high fever, weakness, stomach pains, headache and loss of appetite. Diagnosis can be made by isolation of bacteria from blood culture. Other cultures sites include urine, stool, and duodenal contents, or the bone marrow. If left untreated, typhoid fever can last for 3 weeks or longer and carries a mortality rate of 12% to 30%. There are two types of vaccines to prevent typhoid. One is an inactivated (killed) vaccine given as an injection, and the other type is a live, attenuated (weakened) vaccine which is given orally. Oral vaccines need four doses, given 2 days apart, to be protective, and a booster dose is needed every 5 years for people who remain at risk. A single dose of the injectable vaccine provides protection, but a booster dose is needed every 2 years for people who remain at risk. Vaccines are preventive measures and cannot be used for treatment, which needs drugs like Cefixime, Ofloxacin or other antibiotics. No vaccine is 100% effective and vaccination is not a substitute for being careful about what you eat or drink. Your children can also be protected by natural vaccination (after the infection) but shall need boosters at regular intervals, as well as care about safe drinking water and hygienic practices. Some patients continue to excrete the bacilli for a long time after recovery and are called carriers. These can be identified and treated.