Typhoid fever, a serious illness caused by the Salmonella enterica serotype Typhi (S. Typhi), is experiencing a resurgence, particularly as it becomes increasingly resistant to standard antibiotic treatments. This disease is predominantly found in Africa, Asia, and Latin America, with an estimated 9.2 million cases globally each year. In the United States, around 5,700 cases are reported annually, mostly contracted during international travel, leading to approximately 620 hospitalizations, although fatalities are extremely rare.
Recent research has revealed concerning mutations in the bacterium, most notably the emergence of multidrug-resistant strains, particularly the extensively drug-resistant (XDR) Typhi strain, which is resistant not only to traditional antibiotics but also to newer, potent medications. A significant study conducted in 2022 sequenced the genomes of 3,489 S. Typhi strains from South Asian countries, illuminating the global spread and increase of these resistant strains.
The findings indicate that XDR strains, first detected in Pakistan in 2016, have become the dominant form in certain regions and have spread to areas including North America and Europe, raising alarms among health experts. Jason Andrews, an infectious disease researcher at Stanford University and the study’s lead author, emphasized the urgent need for enhanced prevention efforts and global cooperation in addressing the growing threat of antibiotic resistance.
Traditionally, typhoid fever was treated with common antibiotics such as ampicillin and chloramphenicol. However, by the early 21st century, mutations rendering these drugs ineffective accounted for over 85% of cases in specific countries like Bangladesh, India, and Pakistan. Currently, only one treatment remains effective, and researchers express concern that this too may soon be rendered useless by further mutations.
The bacterium is transmitted through contaminated food, water, or contact with infected materials, underscoring the importance of proper sanitation and hygiene. Symptoms of typhoid fever include sustained fever, abdominal pain, and gastrointestinal disturbances, making early treatment critical to prevent severe health consequences.
To combat the risk of typhoid fever, particularly for travelers to high-risk areas, the Centers for Disease Control and Prevention (CDC) recommends vaccination. Two types are available: an oral vaccine consisting of four pills over four days and an injectable vaccine. Both should be acquired at least two weeks prior to travel, and individuals are encouraged to follow strict food safety guidelines while abroad.
As the fight against antibiotic resistance continues, awareness and preventive measures are vital in preventing the spread of typhoid fever, ensuring that this once seemingly ancient illness does not become a widespread threat in modern times.