Health Alert: Typhoid

The Global threat of typhoid 

Typhoid poses a continuing global health challenge, particularly in regions lacking access to clean water and proper sanitation. Despite advancements in medical treatment and vaccination, typhoid fever is a life-threatening infection and continues to affect millions worldwide. With approximately 9 million cases and 110,000 deaths each year, the challenge of antibiotic resistance further complicates treatment efforts – while the evolving pressures of urbanisation and climate change exacerbate the spread of typhoid in vulnerable communities.  

Here, we outline essential information on prevention, transmission, symptoms and treatment of typhoid fever to help protect you against this global threat.

What steps are being taken to combat typhoid? 

Every year, over 9 million cases of typhoid are recorded, resulting in more than 110 000 deaths. Once a nearly fatal illness with a mortality rate of 10 to 20%, advancements in antibiotic treatment have reduced this to less than 1%.  

Since 2017, the World Health Organisation (WHO) has spearheaded efforts to introduce a typhoid conjugate vaccine into routine childhood immunisation programmes in countries with high incidences of typhoid. This vaccine offers longer-lasting immunity than older versions and can be administered to infants as young as six months. 

Widespread use of the typhoid conjugate vaccine is expected to save lives, reduce the number of people getting sick, and slow the increase of antibiotic resistance. 

Minimise your risk of catching typhoid 

Minimising your risk of typhoid primarily involves avoiding contact with the bacteria. Here are some effective strategies: 

• Vaccine: Vaccines are recommended when travelling to high-risk areas. There are two options: a single shot, taken at least one week before travel, or four oral capsules.  

• Choose food and drinks carefully: Only consume foods that are cooked and served hot, and sealed beverages; avoid raw fruits and vegetables, buffet food, ice, and unpasteurised milk 

• Wash your hands: Use hot, soapy water and scrub thoroughly for at least 30 seconds, especially before eating and after using the toilet. Carry alcohol-based hand sanitiser for times when soap isn’t available.  

• Avoid using untreated water: Use bottled water to brush your teeth and try not to swallow water in the shower.

NOTE: Typhoid vaccines are only 50% to 80% effective, making food and water safety critical. Vaccine effectiveness wears off over time, so repeat immunisation is needed. 

What are the symptoms of typhoid? 

A few weeks after initial symptoms, the illness can cause problems in the intestines, leading to stomach pain and swelling. In serious cases, people may:

• Become confused 

• Struggle to pay attention  

• Not be able to react to the world around them 

In some cases, symptoms may return weeks after the fever has gone away.

What to do if you think you have typhoid  

Symptoms are likely to start slowly, often showing up 1 to 3 weeks after exposure to the bacteria. If you experience prolonged fever, fatigue, or abdominal pain after travelling to a high-risk area, seek medical treatment immediately.  

Did you know? 

Antibiotic resistance: Increasing resistance to different types of commonly used antibiotics makes treatment more complicated. 

Long-term carriers: Some people who recover from typhoid can become long-term carriers of the bacteria without showing any symptoms, continuing to spread the disease. 

Typhoid remains a significant health threat in many parts of the world. While advancements in sanitation, antibiotics, and vaccination have reduced its impact, the emergence of antibiotic resistance poses a growing challenge. By practising preventive measures and supporting global health initiatives, we can help curb the impact of typhoid and safeguard vulnerable populations.