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Impact of a Targeted Typhoid Vaccination Campaign Following Cyclone Tomas, Republic of Fiji, 2010

Heather M. ScobieGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Pacific Technical Support, World Health Organization, Suva, Fiji; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Fiji Centre for Communicable Disease Control, Suva, Fiji; Health Information Unit, Ministry of Health, Suva, Fiji; Fiji Ministry of Health, Labasa, Fiji; Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji

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Eric NillesGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Pacific Technical Support, World Health Organization, Suva, Fiji; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Fiji Centre for Communicable Disease Control, Suva, Fiji; Health Information Unit, Ministry of Health, Suva, Fiji; Fiji Ministry of Health, Labasa, Fiji; Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji

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Mike KamaGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Pacific Technical Support, World Health Organization, Suva, Fiji; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Fiji Centre for Communicable Disease Control, Suva, Fiji; Health Information Unit, Ministry of Health, Suva, Fiji; Fiji Ministry of Health, Labasa, Fiji; Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji

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Jacob L. KoolGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Pacific Technical Support, World Health Organization, Suva, Fiji; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Fiji Centre for Communicable Disease Control, Suva, Fiji; Health Information Unit, Ministry of Health, Suva, Fiji; Fiji Ministry of Health, Labasa, Fiji; Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji

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Eric MintzGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Pacific Technical Support, World Health Organization, Suva, Fiji; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Fiji Centre for Communicable Disease Control, Suva, Fiji; Health Information Unit, Ministry of Health, Suva, Fiji; Fiji Ministry of Health, Labasa, Fiji; Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji

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Kathleen A. WannemuehlerGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Pacific Technical Support, World Health Organization, Suva, Fiji; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Fiji Centre for Communicable Disease Control, Suva, Fiji; Health Information Unit, Ministry of Health, Suva, Fiji; Fiji Ministry of Health, Labasa, Fiji; Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji

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Terri B. HydeGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Pacific Technical Support, World Health Organization, Suva, Fiji; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Fiji Centre for Communicable Disease Control, Suva, Fiji; Health Information Unit, Ministry of Health, Suva, Fiji; Fiji Ministry of Health, Labasa, Fiji; Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji

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Akanisi DawainavesiGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Pacific Technical Support, World Health Organization, Suva, Fiji; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Fiji Centre for Communicable Disease Control, Suva, Fiji; Health Information Unit, Ministry of Health, Suva, Fiji; Fiji Ministry of Health, Labasa, Fiji; Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji

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Sheetalpreet SinghGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Pacific Technical Support, World Health Organization, Suva, Fiji; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Fiji Centre for Communicable Disease Control, Suva, Fiji; Health Information Unit, Ministry of Health, Suva, Fiji; Fiji Ministry of Health, Labasa, Fiji; Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji

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Samuel KorovouGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Pacific Technical Support, World Health Organization, Suva, Fiji; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Fiji Centre for Communicable Disease Control, Suva, Fiji; Health Information Unit, Ministry of Health, Suva, Fiji; Fiji Ministry of Health, Labasa, Fiji; Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji

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Kylie JenkinsGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Pacific Technical Support, World Health Organization, Suva, Fiji; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Fiji Centre for Communicable Disease Control, Suva, Fiji; Health Information Unit, Ministry of Health, Suva, Fiji; Fiji Ministry of Health, Labasa, Fiji; Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji

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Kashmira DateGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Pacific Technical Support, World Health Organization, Suva, Fiji; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Fiji Centre for Communicable Disease Control, Suva, Fiji; Health Information Unit, Ministry of Health, Suva, Fiji; Fiji Ministry of Health, Labasa, Fiji; Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji

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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.

Author Notes

* Address correspondence to Heather M. Scobie, Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Road, MS A04, Atlanta, GA 30333. E-mail: vih8@cdc.gov

Financial support: Funding was provided by the Centers for Disease Control and Prevention and World Health Organization.

Authors' addresses: Heather M. Scobie, Eric Mintz, Kathleen A. Wannemuehler, Terri B. Hyde, and Kashmira Date, Global Immunization Division, Epidemic Intelligence Service, and Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: vih8@cdc.gov, edm1@cdc.gov, kpw9@cdc.gov, tkh4@cdc.gov, and gln7@cdc.gov. Eric Nilles, Division of Pacific Technical Support, World Health Organization, Suva, Fiji, E-mail: nillese@wpro.who.int. Mike Kama and Akanisi Dawainavesi, Fiji Centre for Communicable Disease Control, Suva, Fiji, E-mails: mnkama02@gmail.com and dawainavesia@wpro.who.int. Jacob L. Kool, WHO Country Liaison Office, Port Vila, Vanuatu, E-mail: koolj@wpro.who.int. Sheetalpreet Singh, Health Information Unit, Ministry of Health, Suva, Fiji, E-mail: sheetal.nagra@gmail.com. Samuel Korovou, Ministry of Health, Labasa, Fiji, E-mail: skorokou@yahoo.uk. Kylie Jenkins, Fiji Health Sector Improvement Program, Ministry of Health, Suva, Fiji, E-mail: kylie.jenkins@fhssp.org.fj.

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