Posted By Lance Morgan Typhoid fever is a systemic infection caused by the gram negative bacillus Salmonella typhi. Typhoid fever is spread by the faeco-oral route usually through food or drink that has been contaminated with the excreta of a human case or carrier. It is therfore predominantly a disease of countries with poor sanitation and poor standards of personal and food hygiene. Around two hundred cases of typhoid fever are notified in England and Wales each year, over 80% being acquired abroad principally in Indian sub-continent. Immunisation is advised for: Laboratory workers handling specimens that may contain typhoid organisms Travellers to countries such as Africa, Asia etc. There is no specific recommendation with regard to vaccination of sewage workers.

Posted By Ken Taylor The need for vaccination of operatives against poliomyelitis would be a matter for risk assessment by a competent person on behalf of the employer and/or person in control of the workplace. This notifiable disease spreads through contact with faeces or pharyngeal secretions from an infected person and is considered most infectious for up to 10 days before and after the onset of signs and symptons and the virus is passed in the faeces for up to 6 weeks. In view of the acute nature of the illness some have considered a 3-dose course of vaccination with 10 year reinforcement necessary or advisable for risk groups including those who work in culverts and excavations or who have direct contact with faeces or body fluids. A similar approach may be made to Typhoid and risk groups - with a single dose vaccine reinforced 3 yearly. It might well be considered that personal protection measures, if strictly followed and enforced, make vaccination unnecessary in most circumstances - but that must be a matter for competent assessment. In any event it can be a sound approach to recommend vaccination where there is an evident risk.

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