Extensively Drug-Resistant Typhoid Fever in Pakistan

Key Points

• There is an ongoing outbreak of extensively drug-resistant (XDR) typhoid fever in Pakistan that does not respond to most antibiotics.
• During 2018, cases have been reported in the United Kingdom and in the United States among travelers returning from Pakistan.
• All travelers to Pakistan are at risk of getting XDR typhoid fever. Those who are visiting friends or relatives are at higher risk than are tourists and business travelers.
• Travelers to South Asia, including Pakistan, should take precautions to protect themselves from typhoid fever, including getting a typhoid fever vaccination.
• Travelers to these areas should also take extra care to follow safe food and water guidelines.

What is the current situation?

Health officials in Pakistan have reported an ongoing outbreak of XDR typhoid fever that began in Hyderabad in November 2016. The strain of Salmonella Typhi does not respond to most antibiotics used to treat typhoid fever. The outbreak has spread to the city of Karachi and to multiple districts, and several deaths have been reported. In 2018, three cases of XDR typhoid fever were reported in travelers — one who returned to the United Kingdom, and two who returned to the United States.

Public health authorities in Pakistan are identifying possible typhoid fever cases, starting typhoid vaccination campaigns in the most affected districts, and spreading educational messages about proper handwashing and safe food and water practices.

In the United States, public health officials have increased efforts to quickly interview and test samples from patients with suspected typhoid fever.

Source: CDC