GLOBAL THREAT

Millions at risk as untreatable typhoid strains threaten new global health emergency

MILLIONS could be at risk as untreatable typhoid strains threaten a new global health emergency, experts have warned.

The disease - which causes 21 million cases every year - is often overlooked as an ancient condition from the past, they said.

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Experts have warned that untreatable strains of typhoid threaten a global health emergencyCredit: Oxford Martin School

But new extensively drug-resistant variants of typhoid fever are spreading across international borders.

Cases have been reported in the UK, US, Germany, Pakistan, India, Bangladesh, the Philippines, Iraq, Guatemala, as well as more recently in Australia and Canada.

Researchers from Oxford Martin School are now calling for urgent collective action from global health institutions to dedicate new resources to tackling the highly contagious bacterial infection.

Neglected disease

They say it has become a neglected disease of poorer countries following its elimination in many high-income countries.

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Analysing the past and present of typhoid control, in the journal Clinical Infectious Diseases, the researchers identify a range of actions key to the strategic elimination of typhoid globally.

They say typhoid is still a major global health issue but is largely unrecognised, due to factors including poor surveillance and the complex dynamics of the disease, including new drug-resistant strains.

The scientists also find the availability of cheap credit and sustainable financing schemes for affordable water and sanitary systems at the municipal level have an important role to play in typhoid control - as seen in the elimination of typhoid in the UK and US.

Another finding is that progress on typhoid control will depend on support for independent research and policy decisions within endemic countries to improve water quality.

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The emergence of untreatable strains needs to be taken far more seriously

Dr Samantha Vanderslott

Researchers, including historians, immunologists and social scientists, also say the recent advent of a new generation of typhoid conjugate vaccines can play an important role until clean water and sanitation are in place for those at greatest risk.

Dr Samantha Vanderslott, of the Oxford Vaccine Group, said: "The emergence of untreatable strains needs to be taken far more seriously.

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"Top-down interventions such as vaccination programmes need to be combined with flexible credit to empower local communities, so that they can implement essential infrastructure such as waste disposal, sanitation and clean water systems."

Professor Andrew Pollard, who leads the Oxford Vaccine Group, said: "The escalating problem of antimicrobial resistance means we need urgently to deploy new interventions to tackle typhoid.

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