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Batemans Bay...
posts: 100
reviews: 60

I heard that Typhoid is "rampant" in SE Asia at the moment including Bali.. Anyone heard the same? Maybe an idea to have a shot?

Brisbane, Australia
Destination Expert
for Bali
posts: 12,307
reviews: 69
1. Re: Typhoid

I personally wouldn't travel to SE Asia without my Typhoid and Cholera shots. Outbreaks of these 2 are quite common and happen quite regularly.

posts: 47
reviews: 7
2. Re: Typhoid

I was in Bali in April and caught Typhoid. I was very sick for a long time. Make sure you have your Typhoid shots if you go, my specialist told me it only is about 80% effective, but it's better safe than sorry.

Lombok, Indonesia
posts: 8,290
reviews: 5
3. Re: Typhoid

Typhoid arises form an infection with the Salmonella typhi bacteria.

It is contracted when the infection is passed from person to person often by way of contamination of food and drink. Hand to mouth transmission is common, and sometimes by insects such as flies. Rats and other small animals running around in areas containing active bacteria and then dancing about in the kitchen or upon food produce can also lead to trouble.

Salmonella typhi bacteria must be ingested to cause disease

The bacteria is present in the faces and urine of infected people. Only humans can contract this disease.

If there is no contact with the bacteria present in feces or the urine of an infected person then transmission will not occur.

There is a good description here.. http://medical-dictionary.thefreedictionary.com/typhoid+fever

The disease occurs across the world but is endemic throughout SE Asia, the Indian sub-sontinent, Africa, and western South America.

Poor hygiene habits and public sanitation conditions are responsible for most infections, flies can also cause problems.

Some individuals can be asymptomatic carrier of typhoid fever. These 'carriers' suffer no apparent symptoms, yet they are capable of infecting others, normally due to poor personal hygiene, and especially likely if they are handling food.

It is understood that around 5% of people who contract typhoid continue to carry the disease after they recover.

Diagnosis in the initial stages can be unclear and it can run for up to 4 weeks, if left untreated the outcomes can be grave. Normally treatment is started in absence of a firm laboratory diagnosis when sufficient symptoms are apparent as delays in treatment are ill advised.

Good hand washing technique, good hygiene in food handling and storage and care to avoid contaminated drinking water or water used for food preparation or the washing of utensils, plates and glasses is of course essential.

Due to the various transmission vulnerabilities food that is to be consumed without being cooked must be treated very carefully with good hand and food handling/preparation hygiene. Uncooked foods have extra vulnerabilities.

There are several vaccines available for typhoid, none have higher than 50-80% effectiveness.

The dangers of Typhoid are always an issue, there is no special risk apparent at this time, it is always there, both for Salmonella typhi bacteria and the many other no Typhoid salmonella serotypes.

Lombok, Indonesia
posts: 8,290
reviews: 5
4. Re: Typhoid

Salmonella infections, often referred to as 'Salmonella poisoning' encompasses all the other many serotypes of the of the Salmonella bacterium.

Transmission is by the same routes and methods as above.

Outbreaks have occurred from contamination in fresh and processed foods.

The bacterium often becomes concentrated on a suitable growing medium and is then ingested.

This is why buffets are often a scary place to find food. It can turn up on supermarket shelves as well.

Salmonella is a hardy bacteria and can survive for weeks outside a living body. They survive freezing but utltraviolet radiation and heat accelerate their demise

Cooking food at high temperatures will normally kill tthe bacteria.

Heating food to 55°C (131°F) for 90 min, or to 60°C (140 °F) for 12 min will assist in protecting against Salmonella infection.

To be effective the food be heated for at least ten minutes at 75°C (167°F) so that the centre of the food reaches this temperature.

Flies are a transmission vector for the more common Salmonella bacteria, they can pass it to other flies, and also to rodents.

Bacteria on cross contaminated surfaces remain active and viable for an extended time and can survive in infected flies for the life of that fly (around 4 weeks).

Flies infected with Salmonella enteritidis are capable of infecting other flies as well as the food, water, and the various surfaces they come into contact with.

A Salmonella infection is a common food or drink borne illness and has an onset period of 12-72 hours after infection.

In most cases illness lasts from 4-7 days after onset, and most people recover without treatment, it is just unpleasant.

The most significant danger of Salmonella poisoning arises from dehydration of the sufferer arising from fluid loss resulting from vomiting and diarrhea. It is most important that adaquate fluid levels are maintained, Drinking lots and using re-hydration salts is highly advised or the sufferer could end up in a hospital requiring re-hydration.

If you are unlucky you can pick it up at the airport or elsewhere before you leave, or in the aircraft on the way to your holiday destination, subsequently arriving at the destination and succumbing to the illness a day or so later.

Aircraft are an ideal place for transmission.

If you survive the trip to the destination uninfected then there are plenty of opportunities to pick it up post arrival, especially in areas with poor food hygiene, and little or no food handling training and awareness.

This forum has many discussions on how to avoid this happening and what to do about it if it happens.

Self medication is often discussed by travellers however is highly ill-advised as it is difficult to distinguish what pathogen is actually effecting people, it is not necessarily a Salmonella infection infection and many viral and fungal infections can provide similar symptoms.

People frequently medicate themselves inappropriately with drugs they do not understand and that are entirely inappropriate to their illness.

If you become unwell, rest, avoid alcohol and spicy foods, maintain fluid levels with great enthusiasm, take some rehydration salts and if the problem is prolonged or severe then seek medical assistance from a good provider and notify your insurance company early, not after things have got out of hand.

Edited: 8:12 pm, August 13, 2012
Lombok, Indonesia
posts: 8,290
reviews: 5
5. Re: Typhoid

If you do get unwell and cannot readily access some proprietary rehydration salts from an Apotik (pharmacy) or supermarket then you can make do with ingredients found in any Indonesian kitchen or many roadside warungs.

It is very important to get the balance of the mix right though.

A basic oral rehydration therapy solution can be formulated by using:

30 ml (6 level tsp) of sugar

2.5 ml (1/2 level tsp) of salt,

Dissolve this into 1 litre (4.25 Cups) of clean water (boiled or bottled).

Then eat a couple of bananas so sufficient potassium is also present.

Consume this with vigour if diarrhea or vomiting is depleting you of liquid.

Mixing with a rice water or coconut water is quite acceptable.

Ideally seek out a proprietary packet of rehydration salts or a mix containing:

3.5 gms sodium chloride

2.9 gms trisodium citrate dihydrate (or 2.5 gms sodium bicarbonate)

1.5 gms potassium chloride

20 gms glucose (anhydrous)

Mixed with 1 litre of clean water, consume at room temperature.

Bubur (rice porridge) is a popular local food for someone suffering from a severe gastro intestinal infection and can really help someone who is having problems eating.

Adding a mashed banana (for potassium) and some salt (sodium chloride) is beneficial when appropriate with the other ingredients.

Consuming large amounts of water without the appropriate salt content can lead to problems so make sure to understand at least the basic recipe above with the salt and sugar.

Avoid carbonated soft drinks and 'pops', they will not assist.

Golden Beach...
posts: 1,108
reviews: 74
6. Re: Typhoid

going to Lombok & Gilis SHOULD we get these shots OR is it a matter of just being extra careful with washing hands, we do make sure we use disinfectant wipes before eating.

How long before a holiday should one wait to get the shots if its necessary.

(i hope not I hate needles)

Batemans Bay...
posts: 100
reviews: 60
7. Re: Typhoid

Thanks for all the replies and thanks Hurc for your great overview.

Apparently you need to have the shot a min of 1 month prior to departure..

posts: 47
reviews: 7
8. Re: Typhoid

There is a typhoid tablet you can take if you don't want the needle. I was very cautious used antibacterial etc... and still got it. It's the hygeine of the person pre-paring your food etc that you need to worry about. We mainly ate at the hotel(5 star) and highly reccomended places. I'm going back in december and this time having the shot.

Denpasar, Indonesia
posts: 156
9. Re: Typhoid

In the 5 years of living here I've had typhoid (tipis) once. Its about as fun as dengue fever. The cure most locals use here is a combination or garden worms and hot water mashed into a dirt like drink, Hmmmm yum. There is also the option of the dirty worm drink in pill form which you can buy at your local apotek, how ever they say its not as effective.

I came right after two weeks thanks to dirty worm drink :)

Golden Beach...
posts: 1,108
reviews: 74
10. Re: Typhoid

heehehee Thanks Brad for the suggestions I will give the dirty worm drink a big miss this time!

Hubby & I will ask doctor if the tablet is going to do the trick, prefer it over a needle however we do want to have max protection so will go by our doctors advice.

Thanks happy-snaps for advice, we leave in approx 8 weeks so I will book in for doctor next week.

Prevention is better then cure.