Ancient killer drug-resistant typhoid strains is becoming untreatable and spreading across the globe; study warns
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These infections, traditionally associated with poor sanitation in developing countries, are now resurfacing with a vengeance, this time in the form of extensively drug-resistant (XDR) typhoid strains. Driven by antibiotic resistance and global travel, these Salmonella Typhi superbugs are posing a major challenge to current treatment protocols. Experts warn that the clock is ticking to contain the spread before it becomes a full-blown global crisis.
Drug-resistant typhoid becomes global threat, study warns
A groundbreaking 2022 study found that S. Typhi is developing resistance to nearly all classes of commonly used oral antibiotics. Researchers analysed 3,489 bacterial genomes from India, Pakistan, Nepal, and Bangladesh. The results showed a dramatic rise in XDR strains—those resistant to older drugs like ampicillin and chloramphenicol, and newer ones such as fluoroquinolones and third-generation cephalosporins.
Perhaps most concerning is the worldwide spread of these superbugs. The study documented at least 197 instances of international dissemination of XDR Typhi since 1990. These strains have moved beyond South Asia to East and Southern Africa, Southeast Asia, and even into Western countries like the UK, USA, and Canada. The scale and speed of this spread indicate that antibiotic-resistant typhoid is no longer a regional issue—it is a global emergency.
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Lead author Dr. Jason Andrews of Stanford University warned that the rapid evolution and spread of drug-resistant typhoid demand immediate international intervention. He emphasised that containment efforts must go beyond national borders and include vaccination, sanitation improvements, genomic surveillance, and new drug development.
UK records Typhoid surge in 2024 underscoring global health risk
The UKHSA's 2024 data recorded 702 typhoid cases, marking an 8% increase from 2023—the highest number ever documented.
Though most infections were acquired abroad, this spike emphasizes the global nature of the threat. Typhoid and paratyphoid fever are caused by Salmonella enterica serovar Typhi and are typically spread through contaminated food or water.
According to the BBC, typhoid and paratyphoid; a fever caused nearly 13 million infections and 133,000 deaths annually. These diseases disproportionately affect school-aged children in Asia and Africa, though they are increasingly seen in wealthier nations due to intercontinental travel and migration.
Despite their persistence, these illnesses often remain neglected by health systems in developed countries.
Poor data undermines fight against drug-resistant typhoid
The study also highlights data limitations. Several regions, particularly in sub-Saharan Africa and Oceania, are underrepresented in genomic databases. Most available samples come from limited surveillance sites, meaning that current estimates likely understate the true scale of drug-resistant typhoid's spread.
Scientists are calling for expanded genomic sequencing and international data sharing to track and curb these deadly strains more effectively.
With antibiotic resistance rising, XDR typhoid now represents one of the biggest microbial threats of our time. While vaccines and improved public health systems can slow its advance, only a coordinated, global effort will prevent this ancient killer from claiming more lives in a modern world ill-prepared for it.
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