Volume 90, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



After a category 4 cyclone that caused extensive population displacement and damage to water and sanitation infrastructure in Fiji in March 2010, a typhoid vaccination campaign was conducted as part of the post-disaster response. During June–December 2010, 64,015 doses of typhoid Vi polysaccharide vaccine were administered to persons ≥ 2 years of age, primarily in cyclone-affected areas that were typhoid endemic. Annual typhoid fever incidence decreased during the post-campaign year (2011) relative to preceding years (2008–2009) in three subdivisions where a large proportion of the population was vaccinated (incidence rate ratios and 95% confidence intervals: 0.23, 0.13–0.41; 0.24, 0.14–0.41; 0.58, 0.40–0.86), and increased or remained unchanged in 12 subdivisions where little to no vaccination occurred. Vaccination played a role in reducing typhoid fever incidence in high-incidence areas after a disaster and should be considered in endemic settings, along with comprehensive control measures, as recommended by the World Health Organization.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Crump JA, Luby SP, Mintz ED, , 2004. The global burden of typhoid fever. Bull World Health Organ 82: 346353. [Google Scholar]
  2. World Health Organization, 2008. Typhoid vaccines: WHO position paper. Wkly Epidemiol Rec 83: 4959. [Google Scholar]
  3. Crump JA, Mintz ED, , 2010. Global trends in typhoid and paratyphoid fever. Clin Infect Dis 50: 241246.[Crossref] [Google Scholar]
  4. Fiji Bureau of Statistics, 2007. Fiji Statistics at a Glance. Available at: http://www.statsfiji.gov.fj/. Accessed July 8, 2011. [Google Scholar]
  5. Dunn J, Pryor J, Saketa S, Delai W, Buadromo E, Kishore K, Naidu S, Greene S, Varma J, Chiller T, , 2005. Laboratory-based Salmonella surveillance in Fiji, 2004–2005. Pac Health Dialog 12: 5359. [Google Scholar]
  6. UNICEF, 2010. Fiji Statistics. Available at: http://www.unicef.org/infobycountry/fiji_statistics.html. Accessed June 19, 2013. [Google Scholar]
  7. International Federation of Red Cross and Red Crescent Societies, 2010. Fiji: Cyclone Tomas. Information Bulletin No. 1, March 17, 2010. GLIDE no. TC-2010-000054-FJI. Available at: http://www.pacificdisaster.net/pdnadmin/data/original/FJI_TC_Tomas_2010_IFRC_bulletin1.pdf. Accessed August 16, 2013. [Google Scholar]
  8. United Nations Office for the Coordination of Humanitarian Affairs, 2010. Fiji: Tropical Cyclone Tomas. Situation Report No. 6, April 12, 2010. Available at: http://reliefweb.int/sites/reliefweb.int/files/resources/470D59B7BE1686028525770300728D74-Full_Report.pdf. Accessed August 16, 2013. [Google Scholar]
  9. Jenkins Kylie, 2011. Post Cyclone Tomas Support to Typhoid Fever Control in Fiji: Report to AusAID: Fiji Health Sector Improvement Program.
  10. Tapa S, Cvjetanovic B, , 1975. Controlled field trial on the effectiveness of one and two doses of acetone-inactivated and dried typhoid vaccine. Bull World Health Organ 52: 7579. [Google Scholar]
  11. DeRoeck D, Ochiai RL, Yang J, Anh DD, Alag V, Clemens JD, , 2008. Typhoid vaccination: the Asian experience. Expert Rev Vaccines 7: 547560.[Crossref] [Google Scholar]
  12. Vollaard AM, Ali S, van Asten HA, Widjaja S, Visser LG, Surjadi C, van Dissel JT, , 2004. Risk factors for typhoid and paratyphoid fever in Jakarta, Indonesia. JAMA 291: 26072615.[Crossref] [Google Scholar]
  13. Bissell RA, , 1983. Delayed-impact infectious disease after a natural disaster. J Emerg Med 1: 5966.[Crossref] [Google Scholar]
  14. Toole MJ, Noji EK, , 1997. Communicable disease and disease control. , ed. The Public Health Consequences of Disasters. New York: Oxford University Press, 83100. [Google Scholar]
  15. Polonsky J, Luquero F, Francois G, Rousseau C, Caleo G, Ciglenecki I, Delacre C, Siddiqui MR, Terzian M, Verhenne L, Porten K, Checchi F, , 2013. Public health surveillance after the 2010 Haiti earthquake: the experience of medecins sans frontieres. PLoS Curr 7: 5. [Google Scholar]
  16. Kouadio IK, Aljunid S, Kamigaki T, Hammad K, Oshitani H, , 2012. Infectious diseases following natural disasters: prevention and control measures. Expert Rev Anti Infect Ther 10: 95104.[Crossref] [Google Scholar]
  17. Spiegel PB, Le P, Ververs M-T, Salama P, , 2007. Occurrence and overlap of natural disasters, complex emergencies and epidemics during the past decade (1995–2004). Confl Health 1: 2.[Crossref] [Google Scholar]
  18. Ochiai RL, Acosta CJ, Agtini M, Bhattacharya SK, Bhutta ZA, Do CG, Dong B, Chen X, Stanton B, Kaljee L, Nyamete A, Galindo CM, von Seidlein L, DeRoeck D, Jodar L, Clemens J, , 2007. The use of typhoid vaccines in Asia: the DOMI experience. Clin Infect Dis 45: S34S38.[Crossref] [Google Scholar]
  19. Ochiai RL, Acosta CJ, Danovaro-Holliday MC, Baiqing D, Bhattacharya SK, Agtini MD, Bhutta ZA, Canh do G, Ali M, Shin S, Wain J, Page AL, Albert MJ, Farrar J, Abu-Elyazeed R, Pang T, Galindo CM, von Seidlein L, Clemens JD, Domi Typhoid Study Group; , 2008. A study of typhoid fever in five Asian countries: disease burden and implications for controls. Bull World Health Organ 86: 260268.[Crossref] [Google Scholar]
  20. Bodhidatta L, Taylor DN, Thisyakorn U, Echeverria P, , 1987. Control of typhoid fever in Bangkok, Thailand, by annual immunization of schoolchildren with parenteral typhoid vaccine. Rev Infect Dis 9: 841845.[Crossref] [Google Scholar]
  21. Yang HH, Wu CG, Xie GZ, Gu QW, Wang BR, Wang LY, Wang HF, Ding ZS, Yang Y, Tan WS, Wang WY, Wang XC, Qin M, Wang JH, Tang HA, Jiang XM, Li YH, Wang ML, Zhang SL, Li GL, , 2001. Efficacy trial of Vi polysaccharide vaccine against typhoid fever in south-western China. Bull World Health Organ 79: 625631. [Google Scholar]

Data & Media loading...

Supplementary PDF

  • Received : 11 Dec 2013
  • Accepted : 14 Feb 2014
  • Published online : 04 Jun 2014

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error