The issue
More than 11 million people are infected with typhoid every year, mainly in low-income countries.
Typhoid fever is a life-threatening disease caused by the bacterium Salmonella Typhi. It is mainly transmitted through contaminated food or water. Symptoms include prolonged fever, headache, nausea, loss of appetite, constipation and sometimes diarrhoea. If typhoid is not treated, it can kill up to 30% of those who are infected.
Disease burden
While improvements in living conditions and increased access to antibiotics have largely eliminated typhoid from industrialised countries, it remains a serious threat in low-income countries.
Typhoid affects 11-21 million people each year, causing 128,000 to 161,000 deaths - mainly in sub-Saharan Africa and South Asia. Almost a third of all cases are among children under five, highlighting the importance of being able to prevent the disease in young children.
Antibiotic resistance
With appropriate antibiotic treatment, the case fatality rate of typhoid can drop to less than 1%. However, in recent years there has been an alarming increase in antimicrobial resistance of Salmonella Typhi. Drug-resistance is spreading across Asia and Africa, posing a serious threat to public health.
The emergence of drug-resistance could stall efforts to control the disease and force a shift of focus towards prevention rather than treatment, mainly through immunisation and improved access to safe water, sanitation and hygiene.
Vaccine-preventable
Typhoid conjugate vaccines, in combination with increased access to improved sanitation and clean water, can significantly reduce the spread and burden of typhoid fever around the world.
In October 2017, WHO recommended the introduction of typhoid vaccine for children over six months in endemic countries. It also recommended catch-up vaccination when feasible and appropriate, prioritising children and adolescents up to 15 years of age.