由「不活性傷寒疫苗之副作用」談軍中傷寒防治策略

Two specific aims of this study are :(1) to evaluate the adverse reactions of killed parenteral typhoid vaccine (TAB), and (2) to give recommendations for military typhoid control strategies in Taiwan, R.O.C. Eighty four (82.4%) male soldiers (mean age 21.9±0.7) in one naval ship (total 92 persons, age 20-28y/o) received the TAB vaccine with a dosage of 0.5cc through subcutaneous injection in June, 1994. Seventy three (86.9%) persons answered a structured questionnaire about adverse reactions. Among them, 33 cases (45.2%) had at least one of the following adverse reactions: local tenderness at the injection site, pain and soreness of arm, fever and general malaise, local swelling at injection site, dizziness, diarrhea, and headache. One case with neck lymphadenopathy was finally diagnosed as acute lymphoblastic leukemia which was detected earlier through this immunization. According to adverse reactions and vaccine delivery practices between TAB and Ty21a vaccines, we recommend to stop using TAB vaccine but immunize soldiers with Ty21a vaccine for its better protection and less side effects. Other recommendations include: (1) to screen ”stool culture” of typhoid bacilli routinely among food handlers, (2) to set up a periodic bacterial surveillance of water supply, and (3) to immunize hospital diagnostic laboratory personnel with Ty2la vaccine.