Fondation Merieux

A family foundation dedicated to fighting infectious diseases

Typhoid fever meeting: Toward vaccine introduction policy

22 April 2007, Annecy (France)

The first step towards developing news recommendations for vaccination

Typhoid fever is passed on by the ingestion of food or drink contaminated by a bacteria, the Salmonella Typhi. The illneses results in a long fever, stomac pain, feeling sick and nauseousness. If this infection is not correctly diagnosed and treated, it could degenerated into septicaemia, coma and death.

During the international meeting called 'typhoid fever a neglected disease: Toward vaccine introduction policy', experts attempted to develop a new global strategy of vaccination against typhoid fever. The meeting was organised by Fondation Mérieux at the conference centre Les Pensières (Veyrier du Lac, near Annecy, France), in collaboration with the IVI. During three days (2–4 April), about sixty experts attended: vaccinologists, immunologists, epidemiologists; vaccines producers (Americans, Europeans, Asians, Africans); representatives from WHO, FDA, GAVI, Bill and Melinda Gates Foundation. The meeting has was funded by partners of Fondation Mérieux: Sanofi Pasteur, Merck and Co Inc, GlaxoSmithKline APAJH and Korean IVI.

300 000 to 400 000 deaths are due to typhoid fever each year and this disease especially affects children (2–19 years old). This infection is as lethal as cervical cancer and more lethal than meningitis and the Japanese encephalitis. These three pathology are some of priorities for WHO, whereas the typhoid fever is not one of them. Even so, this infection remains a serious threat in developing countries.

Due to the improvement of hygiene, better access to drinking water and the construction of quality sewage system, the typhoid fever has disappeared in developed countries. But these measures of prevention are very difficult to set up in developing countries because it is very expensive. Another problem has been the appearance of multiresistances to antibiotics for ten years. Then it is not easy to have effectiveness treatments and there are regularly epidemics as in Tadjikistan in 1997. Thus, vaccination appears at the moment the best solution in order to fight typhoid fever in developing countries.

Developing a global strategy of vaccination experts gathered together at the Fondation Mérieux in order to discuss the development of a global strategy of vaccination against this infection.

Countries such as Indonesia, China and Vietnam have already used with success the typhoid fever vaccination at the time of epidemics, natural disasters or when they wanted to protect some children in schools. These results were presentedand discussed during the meeting. The conclusions of the experts are: the best solution would be the vaccination of children of school age, because vaccination is successful when it concerns people which are most affected by the infection. In the case of typhoid pever, it is children and teenagers. The vaccination should be carried out with one of two vaccines which have a 70% effectiveness. One is a single dose by injection, the other is a taken three times oral dose. The protection is obtained one week later.

Experts also evaluate the price of the vaccination: 0.60 dollars per person! This is a cheap cost in comparison with the cost of hospitalisation and treatment of the illness. This small cost should motivated the creation of a global strategy of vaccination in developing countries.

After this meeting, OMS will almost certainly organise a new meeting in September in order to write internationals recommendations of vaccination against typhoid fever.

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