Salmonella enterica serotype Typhi (S Typhi) causes typhoid fever and carries a great death burden globally per annum. Typhoid fever mostly occurs in endemic areas with poor water, sanitation, and hygiene (WaSH) infrastructure. 

Asymptomatic chronic carriers and acutely infected patients cause continued transmission through the shedding of the organism in the feces. If left untreated, 10%-15% of patients may develop serious complications.

The high morbidity and mortality of typhoid fever in low- and middle-income countries demands an integrated control approach, which may ultimately eliminate the disease in the 21st century. Yet there are challenges faced in pursuit of typhoid fever elimination. One such problem is a delay in implementing typhoid conjugate vaccines in the national Expanded Program on Immunization. Additionally, Inadequate diagnostic methods and the high burden of antibiotic-resistant strains complicate clinical management and, ultimately, prognosis. 

Detecting asymptomatic carriers will help to prevent the transmission of disease. Furthermore, Integrated control, including WaSH, effective treatment, health education, point-of-care diagnostics, and vaccination, will help to win over this deadly disease.

Source: Khanam F, Ross AG, McMillan NAJ, Qadri F. Toward Typhoid Fever Elimination. International Journal of Infectious Diseases. 2022;119:41-43. https://doi.org/10.1016/j.ijid.2022.03.036.