By NewsDesk  @infectiousdiseasenews

The Ireland Health Protection Surveillance Centre (HPSC) in Dublin is reporting an significant increase in typhoid fever cases in 2019.

Salmonella serotype Typhi
Typhoid image/CDC

Specifically, a large increase in typhoid cases have been reported among travelers returning from Pakistan.

Historically, about nine cases of typhoid are reported annually in Ireland with India being the most common country where travelers contracted the disease.

In 2019 to date, there have been 23 typhoid notifications, twelve of which reported recent travel to Pakistan. Seven of these Pakistan-associated cases were less than 15 years of age.

Typhoid fever is a serious water-borne infection caused by the bacterium Salmonella Typhi that spreads through contaminated food and water. It typically causes fever, headache, nausea and severe loss of appetite. In rare cases, typhoid fever can be fatal. Its treatment with antibiotics is essential.

Since 2017, the Government of Pakistan has been responding to an increasing number of extensively drug-resistant (XDR) typhoid fever cases in Sindh province. This XDR-typhoid strain is resistant to ampicillin, trimethoprim/sulfamethoxazole, chloramphenicol, fluoroquinolones and ceftriaxone. Since November 1, 2016, over 15,000 typhoid cases were reported from Sindh province, around two-thirds of which were found to be XDR, potentially limiting therapeutic options. The increase has been particularly acute since 2018.

To date, among the Pakistan-associated typhoid cases in Ireland in 2019, three are XDR; this is the first time XDR-typhoid cases have been identified by the National Salmonella Shigella and Listeria Reference Laboratory (NSSLRL) in Ireland.

HPSC recommends the following steps to minimise the risk of contracting typhoid while travelling:

  1. Always try to ensure that you wash your hands in clean, hot water before eating or drinking and after using the toilet.
  2. Avoid risky foods and drinks
  3. Ensure that you are vaccinated against typhoid fever if travelling to a high risk area.