All volunteers provided written informed consent. This study was approved by the United Kingdom National Research Ethics Service (14/NW/1455). Thirty healthy adult volunteers were enrolled into the study. Sixteen volunteers (4 males and 12 females) were randomly selected for oral vaccination with live-attenuated S. Typhi (Ty21a; Vivotif). Three doses of a single oral capsule were taken on days 0, 2, and 4, approximately 1 hour before a meal, with a cold or lukewarm drink. Fourteen volunteers (2 males and 12 females) were randomly assigned to an unvaccinated control group.

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