Enteric fever continues to affect millions of people who do not have adequate access to clean water and sanitation. Typhoid and paratyphoid fever burden in South Asia is largely acknowledged, yet the current estimates of incidence, severity, and cost of illness from India are lacking. A recent review by Kumar S. et al. presents findings from two years of surveillance conducted by the Surveillance for Enteric Fever in India (SEFI) network. 

Their findings provide evidence of the high disease burden and cost of illness—the latter mainly borne by patients in the absence of universal healthcare coverage in India. Besides the current scenario of the COVID-19 pandemic, these data indicate that the often-overlooked problem of typhoid is still a persistent public health problem in India. 

The data in this supplement show that the burden is present in the most vulnerable communities in India, who have less access to safe and treated water and improved sanitation. The incidence rates in young children are amongst the highest seen worldwide, representing another vulnerable group that would benefit from nationally sanctioned typhoid conjugate vaccines (TCV) campaigns. Typhoid conjugate vaccines, produced by multiple Indian manufacturers and recommended for use in high-burden settings, guarantee that the management approaches to typhoid are an immediately available solution to this public health problem.

Kumar S, Ghosh RS, Iyer H, Ray A, Vannice K, MacLennan C, Shewchuk T, Steele D. Typhoid in India: An Age-old Problem With an Existing Solution. J Infect Dis. 2021 Nov 23;224(Supplement_5): S469-S474. doi: 10.1093/infdis/jiab441. PMID: 35238361; PMCID: PMC8892544.