Take on Typhoid Newsletter October 2019

Taking on Typhoid

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In this issue:

A new supplement: The past, present, and future of typhoid control

A new supplement, “Making a Difference? The past, present, and future of typhoid control” was published today in Clinical Infectious Diseases. This work is the culmination from a 2018 international workshop in Oxford that brought together medical humanities and science experts, international donors, and policymakers to assess historical and contemporary aspects of typhoid control. The workshop—and the resulting six interdisciplinary articles—focuses joint efforts to study the biological, medical, social economic, cultural, and historical factors influencing typhoid prevalence. The authors explore topics that include innovative financing mechanisms to curb typhoid, to the effects of post 1930’s antibiotic use, the current typhoid burden, and surveillance gaps in six countries today. The supplement suggests a multidisciplinary approach to tackle typhoid and shows there is no universal roadmap for typhoid control. Instead, international strategies for typhoid control should be multipronged, locally tailored, and pair long-term surveillance and health system strengthening with near term solutions, including TCV introduction.

Laos stakeholder meeting

Earlier this month, nearly 80 stakeholders convened in Vientiane, Laos, to discuss the country’s typhoid prevention and control strategy. The meeting was hosted by the Ministry of Health with support from the Typhoid Vaccine Acceleration Consortium (TyVAC) and other development partners. The meeting provided an opportunity for stakeholders to share their work and understand the typhoid burden, disease surveillance, typhoid diagnosis, treatment and prevention measures and review the current status of typhoid surveillance and existing data in Laos. Participants discussed outbreak response measures and opportunities for typhoid control, including TCVs, supported by Gavi, the Vaccine Alliance and other international partners. By the end of the meeting, participants identified the way forward for both short- and long-term typhoid control in Laos. Partners agreed to present the meeting report and presentations to the National Immunization Technical Advisory Group and the Steering Committee of the Ministry of Health for their assessment.

Advocating to take on typhoid: New blog series

Frontline health care workers—including physicians, nurses, laboratory personnel, community health workers, and social mobilizers—confront typhoid in their communities every day, and therefore have an integral role in typhoid prevention and control. Last month, we shared the stories of four such health care workers in our latest blog series, “Prevention in Action.” From India and Bangladesh to Pakistan and Zimbabwe, each story offers a glimpse into the incredible people and work behind the global effort to take on typhoid.

Take on Typhoid and the American Society of Tropical Medicine and Hygiene

Join Take on Typhoid for a full slate of enteric fever research presentations and gatherings at the annual meeting of the American Society of Tropical Medicine and Hygiene, taking place at National Harbor, Maryland, from November 20–24. Friday, November 22, will be a particularly full day with symposia on disease burden, novel methods for enteric fever surveillance, and TCV introduction, as well as a lunchtime reception hosted by Take on Typhoid. We are keeping an updated schedule of enteric fever talks and events on our website—please email us if you have any presentations to add to the list.

World Water Week

Each year, World Water Week is organized by the Stockholm International Water Institute as a “collaborative learning experience” that brings together perspectives and experiences between the scientific, business, policy, and civil societies related to water topics. It aims to be the annual focal point for global water issues, working to achieve a “water wise world.” This past August, TyVAC attended World Water Week with an eye towards connecting with key water, sanitation, and hygiene (WASH) stakeholders, identifying potential new partners, and seeking opportunities to integrate TCV introduction and WASH programs.

The key theme this year was about “including all,” with discussions focused on equity and ensuring access to safe water and improved sanitation. More than 4,000 participants from 138 countries joined conversations about climate change, WASH behaviors, and a long program of other topics. Given increasing rates of drug-resistant typhoid, more severe weather events, and ongoing migration and urbanization changes, the urgency for an integrated approach is as great as ever. TCVs alone cannot control typhoid; WASH must also be part of the solution. We will continue to raise awareness about the importance of a comprehensive and integrated typhoid prevention and control approach.

Outbreak reports

Health officials in Pakistan continue to report cases of extensively drug-resistant (XDR) typhoid in an ongoing outbreak that began in November 2016 in Hyderabad, Sindh Province. The outbreak has since spread to provinces throughout the country, and several deaths have been reported. Cases of XDR typhoid have also recently been reported in travelers returning from Pakistan in Australia, Canada, Denmark, Taiwan, the United Kingdom, and the United States. The US Centers for Disease Control and Prevention has issued a Level 1 travel alert for travelers visiting Pakistan.

More than 850 cases of typhoid fever have been reported in Harare, Zimbabwe, in 2019. Failing sanitation infrastructure and an ongoing water shortage have been cited as key factors contributing to increased transmission. The most recent outbreak in the high-density suburb of Glen View was traced to an unprotected well.

Kamle District in northeastern India recently reported 30 cases of typhoid fever caused by contaminated drinking water sources. Around the same time, the Ministry of Health of Singapore and the Singapore Food Agency reported 18 hospitalizations due to typhoid fever. The cause of the cases is unknown, however officials from both agencies are investigating whether the cases are local or overseas imports.

Scientific publications


Diagnostic host gene signature for distinguishing enteric fever from other febrile diseases

Epidemiological trend of typhoid and paratyphoid fevers in Zhejiang Province, China from 1953 to 2014

The global burden of non-typhoidal salmonella invasive disease: A systematic analysis for the Global Burden of Disease Study 2017

The implications of extensive drug-resistant typhoid Fever: A case report

Investigation of the role of typhoid toxin in acute typhoid fever in a human challenge model

Tackling typhoid fever in South Asia: Lessons from Vietnam

Visit our publications page for more recent research

Typhoid: A ghost of the past that never really went away

Guarding against infection from all possible angles

Prevention in action blog series

A unique opportunity: Typhoid control in Madagascar

The importance of water and sanitation when we take on typhoid

Stories of typhoid: The Pandeys

“A wake-up call”: A surgeon raises his voice for typhoid conjugate vaccines

New research explores role of typhoid toxin

All posts available on the blog