Though typhoid fever is a rare disease in the United States, the proportion of cases caused by drug- resistant Salmonella typhi is increasing.
In the latest issue of the Journal of the American Medical Association, researchers from the Centers for Disease Control and Prevention (CDC) say the resistant bacterium is mostly due to foreign travel, most often to the Indian subcontinent; in particular India, Pakistan, and Bangladesh.
During the study period (1999-2006), 1902 cases of typhoid fever were reported to the CDC; 51% of these cases were in California, New York, and New Jersey. For the 1830 cases with travel information available, 79% were travel associated; 67% of patients with travel-associated typhoid had visited India, Pakistan, or Bangladesh.
As far as antibiotic resistance the researchers found: 2,016 S Typhi isolates sent to the CDC by U.S. public health laboratories for antimicrobial susceptibility testing, 272 (13%) were resistant to chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole. In addition, 758 isolates (38%) were resistant to nalidixic acid, and the vast majority of these isolates (97%) had decreased susceptibility to ciprofloxacin.
Typhoid fever is a life-threatening illness caused by the bacterium Salmonella Typhi.
Salmonella Typhi lives only in humans. Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. In addition, a small number of persons, called carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed S. Typhi in their feces (stool).
You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding S. Typhi or if sewage contaminated with S. Typhi bacteria gets into the water you use for drinking or washing food. Therefore, typhoid fever is more common in areas of the world where handwashing is less frequent and water is likely to be contaminated with sewage.
You can avoid this devastating disease by avoiding risky foods and drinks and getting vaccinated against typhoid fever prior to overseas travel.
More info on Typhoid fever and the vaccination
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