Typhoid Vaccine: Essential For A Safe Belize Adventure

Belize is a country in Central America, bordered by Mexico and Guatemala. The country has a tropical climate influenced by the sea and mountain ranges. While there are no mandatory vaccinations for Belize, the CDC and WHO recommend the following: typhoid, hepatitis A, polio, yellow fever, chikungunya, rabies, hepatitis B, influenza, COVID-19, pneumonia, meningitis, chickenpox, shingles, Tdap (tetanus, diphtheria, and pertussis), and MMR (measles, mumps, and rubella).

The CDC recommends that all eligible travelers be up to date with their COVID-19 vaccines. There has been evidence of chikungunya virus transmission in Belize within the last 5 years, and the CDC suggests that travelers who are 65 years or older, or who plan to stay in the country for 6 months or more, consider getting the chikungunya vaccine. The CDC also recommends that unvaccinated travelers younger than 60 get the hepatitis A vaccine before traveling to Belize.

In addition to vaccinations, it is important to take precautions to avoid insect bites, practice food and water safety, and prevent and treat animal bites.

Typhoid vaccine effectiveness and duration

The effectiveness of typhoid vaccines varies depending on the type of vaccine administered. The two types of typhoid vaccines available in the United States are the Vi capsular polysaccharide vaccine for parenteral use (Typhim Vi) and the oral live-attenuated vaccine (Vivotif).

The Vi polysaccharide vaccine is administered as a single injection and is approved for adults and children aged 2 years and above. It has an estimated 2.5–3.0-year cumulative efficacy of 55% (95% confidence interval [CI] = 30%–70%). A trial in Kolkata, India, found a protective effectiveness of 61% (CI = 41%–75%) among all participants, including 80% (CI = 53%–91%) effectiveness among those aged 2–4 years. However, a trial in Karachi, Pakistan, showed no protection among children aged 2–4 years.

The oral Ty21a vaccine is administered in 4 doses on alternating days over 1 week and is approved for adults and children aged 6 years and above. It has an estimated 2.5–3.0-year cumulative efficacy of 48% (CI = 34%–58%).

Regarding duration, the manufacturer of the Vi polysaccharide vaccine recommends a repeat dose every 2 years after the primary dose if continued or renewed exposure to Salmonella Typhi is expected. On the other hand, the manufacturer of the Ty21a vaccine recommends revaccination with the entire 4-dose series every 5 years if continued or renewed exposure to Salmonella Typhi is expected.

Other recommended vaccines for Belize

The CDC and WHO recommend the following vaccinations for Belize:

• Hepatitis A – Recommended for most travellers, especially those who are unvaccinated and younger than 60.
• Polio – Required if arriving from a region with active polio transmission. A single adult booster is recommended.
• Yellow Fever – Required if travelling from a country with a risk of yellow fever transmission.
• Rabies – Recommended for long-term travellers and those who may come into contact with animals.
• Hepatitis B – Recommended for travellers to most regions, especially healthcare workers.
• Influenza – Recommended for all travellers, with components changing annually.
• COVID-19 – Recommended for travel to all regions, both foreign and domestic.
• Pneumonia – Recommended for all travellers aged 65+ or immunocompromised.
• Meningitis – Recommended for anyone unvaccinated or at increased risk, especially students.
• Chickenpox – Recommended for those unvaccinated and who did not have chickenpox.
• Shingles – Can be given to those who have had shingles.
• Tdap (Tetanus, Diphtheria and Pertussis) – Only one adult booster of Pertussis is required.
• Measles, Mumps and Rubella (MMR) – Recommended for anyone unvaccinated and/or born after 1957. A one-time adult booster is recommended.

Additionally, the NHS recommends the following vaccines:

• Hepatitis A.
• Rabies.
• Hepatitis B – Only for those at the highest risk.

Preventing mosquito bites in Belize

Mosquitoes are most active during the rainy season (June-November) and in areas with stagnant water, like marshes, puddles, and rice fields. They are more common in the lower, flatter regions of Belize than in the hills. Even in the highlands, old tires, cans, and roadside puddles can provide the habitat necessary to produce swarms of mosquitoes.

• Use a mosquito net tucked underneath your mattress.
• Limit the amount of skin you expose—long sleeves, pants, and socks will do more to prevent bites than the strongest chemical repellent.
• Choose accommodations with good screens, and if this is not possible, use a fan to blow airborne insects away from your body as you sleep.
• Avoid being outside or unprotected in the hour before sunset, when mosquito activity is heaviest.
• Consider purchasing a lightweight backpackers’ net, either freestanding or to hang from the ceiling, before you come south—mosquito nets are more expensive in Belize than at home.
• Some accommodations provide nets; others are truly free of biting bugs and don’t need them. If you know where you’re staying, ask before you arrive whether you’ll need a net.
• Once in Belize, you can purchase mosquito coils, which burn slowly, releasing a mosquito-repelling smoke; they’re cheap and convenient, but try to place them so you’re not breathing the toxic smoke yourself.
• Use EPA-registered repellents with DEET, picaridin, or OLE for protection.
• If bitten, wash the area, avoid scratching, and apply remedies. Seek medical help for severe reactions.

Food and water safety in Belize

Food and water safety are important considerations when travelling to Belize. Here is some information to help you stay safe and healthy during your trip.

Water Safety

Tap water in Belize is generally safe to use for brushing teeth, cooking, and rinsing food. However, it is recommended to drink purified water or stick to bottled beverages. If you are caught without access to purified water, you can use a Steripen to purify water from the tap. It is also advised to avoid swallowing water from streams, ponds, and lakes.

Food Safety

Food in Belize is generally considered safe, especially in high-end lodgings and restaurants that cater to tourists. To further reduce the risk of foodborne illnesses, it is recommended to follow these guidelines:

• Opt for fully cooked dishes
• Avoid raw seafood
• Choose eateries with good hygiene practices
• Wash your hands frequently and practise good hand hygiene
• Avoid unsanitary street food
• Avoid lettuce and raw vegetables unless you have washed and disinfected them yourself
• Avoid fruit unless you have peeled it yourself

Vaccinations

While no vaccinations are required to enter Belize, it is recommended to be up-to-date with routine immunisations such as Hepatitis A, Hepatitis B, Typhoid, and Rabies.

Other health risks in Belize

Belize is a developing Central American nation with a range of health risks for travellers to be aware of. Here is some detailed information on other health risks in Belize:

Food and Water-borne Diseases

Belize has a tropical climate, and food and water safety should be a priority for visitors. Tap water is not potable, and travellers should take precautions to avoid drinking contaminated water. This includes ensuring that ice is made from safe water sources and being cautious of water-based activities in freshwater sources such as lakes, ponds, and rivers. It is also important to avoid raw seafood and unpasteurised dairy products, as well as raw or undercooked meat or fish. It is recommended to opt for fully cooked dishes and eateries with good hygiene practices.

Vector-borne Diseases

Vector-borne diseases are those transmitted by insects such as mosquitoes, ticks, and fleas. These include chikungunya, dengue fever, Zika virus, Chagas disease, leishmaniasis, and West Nile virus. The best way to prevent these diseases is to reduce the risk of insect bites by using insect repellent, wearing long-sleeved shirts and long pants, and staying in accommodations with screens or air conditioning. Additionally, removing standing water, where insects breed, is important.

Other Infectious Diseases

Belize is also home to a variety of venomous scorpion, snake, and spider species. It is important to be aware of these and other potential hazards when participating in outdoor activities such as hiking or camping.

Non-infectious Risks

Belize has a high risk of violent crime, including armed robbery, assault, and sexual assault, especially in Belize City, San Pedro, Caye Caulker, and areas surrounding Belmopan and Mayan archaeological sites. Protests and demonstrations also occur and have the potential to turn violent. It is important to stay alert and aware of your surroundings, monitor travel advisories, and follow local news.

Transportation Safety

There is a significant risk of traffic-related injuries or death in Belize, with poorly enforced speed and seatbelt laws and a high road traffic death rate. It is important to carefully assess the safety of transportation options and follow basic safety tips such as wearing a seatbelt and avoiding driving at night.

Frequently asked questions