No, it’s not a fever dream.
A deadly disease that toppled ancient civilizations is becoming increasingly resistant to antibiotics, posing a significant threat in certain parts of the world.
“Despite advances in vaccination and treatment strategies, typhoid fever continues to affect millions annually, leading to substantial morbidity and mortality, and there continue to be large-scale outbreaks,” an international team of researchers recently wrote in the journal Scientific Data.
The World Health Organization estimates that about 9 million people become ill from the life-threatening bacterial infection and 110,000 people die from it annually.
Typhoid fever is common in Southeast Asia, Sub-Saharan Africa, South America and Eastern Europe, where sanitation and water quality are poor.
Roughly 5,700 illnesses and 620 hospitalizations from typhoid occur in the US each year, with most cases linked to international travel, according to the Centers for Disease Control and Prevention.
The University of Wisconsin at Madison reported in February that a campus cafe worker had typhoid, warning students of potential exposure to Salmonella Typhi.
The bacteria are spread through contaminated food or water or contact with infected people.
Once the bacteria enter the body, they typically cause a high fever, fatigue and stomach cramps within one to three weeks.
Prompt antibiotic treatment is crucial to prevent severe complications, like intestinal hemorrhage, organ failure and sepsis, and death.
The problem is that S. Typhi are developing resistance to antibiotics through genetic mutations, allowing them to survive even when exposed to drugs that would normally kill them.
Researchers sounded the alarm about the rise in drug-resistant (XDR) Typhi in 2022 after studying the strains contracted from 2014 to 2019 in Nepal, Bangladesh, Pakistan and India.
“Typhoid was once treatable with a set of pills and now ends up with patients in hospital,” Jehan Zeb Khan, the clinical pharmacist at a hospital in northern Pakistan, told The Guardian last fall.
Pakistan has been grappling with drug-resistant typhoid since 2016, with the overuse of antibiotics a significant contributor. Antibiotic-resistant infections kill at least 1.2 million people worldwide each year.
Other factors include limited access to clean water and sanitation and little public awareness of the disease.
Experts recommend expanding access to typhoid immunization and funding new antibiotic research.
“XDR-typhoid is the final warning sign. After this we will enter a stage where the superbug won’t respond to any drugs at all,” Khan said. “That means we will go back to when typhoid was a more deadly disease. And that really worries us.”
