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If everyone in Fiji is vaccinated against typhoid it might be possible to wipe out the disease in the South Pacific nation, the World Health Organisation (WHO) says.
At least 263 people are infected with typhoid Fiji, leading the country's health ministry to declare a public health state of emergency in some regions last week.
But the WHO representative responsible for communicable diseases, Jacob Kool, said studies found there were at least seven times as many cases of typhoid than those reported.
"Most cases are actually missed because it's kind of difficult to make the diagnosis," Kool said.
The Australian government have dedicated almost $1 million to fighting the disease and 70,000 doses of vaccine were sent to Fiji in the wake of tropical Cyclone Tomas in March.
Injections begun on Tuesday in the highlands of the country's largest island, Viti Levu, with 173 villagers getting jabbed.
"We were just about to start in the most cyclone-affected areas and then this big outbreak occurred in an unexpected area so that's where they're actually starting," Kool said.
"A lot of these outbreaks occur after mass gatherings for funerals or weddings and such when people eat the same meals and then apparently someone who was carrying the bacteria must have made the food and must of infected all of these people."
Kool said if everyone over the age of two in the country were immunised - around 900,000 people - it may be be possible to completely eradicate the disease.
"There are so many outbreaks currently occurring in Fiji that if you just vaccinate against the outbreak you might be too late," he said.
"People are very mobile in Fiji so by the time you do your vaccination and by the time the vaccine is actually catching on, it may already be spreading.
"Typhoid fever is a disease that is only carried by humans, so if you vaccinate all humans you might be able to completely eradicate it, at least from Fiji.
A meeting of international experts is slated for August with representatives from AusAid, the International Vaccine Institute and the Centre for Disease Control coming together to discuss the rapid spread of typhoid in Fiji.
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