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Christine Dumontet : Questions santé voyage et vaccination


Pakistan: Extensively drug-resistant typhoid

31 January 2019

Pakistan: Extensively drug-resistant typhoid

Government of Canada: Travel health notice: January 30, 2019


There is an ongoing outbreak of extensively-drug resistant (XDR) typhoid fever in Pakistan that does not respond to most antibiotics.


Cases were first reported in the province of Hyderabad and the city of Karachi, but the outbreak has now spread to other parts of the country.


In 2018, cases of XDR typhoid fever were reported in travellers coming from Pakistan to the United States and the United Kingdom.


Typhoid fever is an illness that is caused by a type of Salmonella bacteria called Salmonella typhi.


Typhoid fever can be spread to humans through:

  • eating food or drinking beverages that have been handled by a person who is infected with typhoid fever
  • drinking water that has been contaminated with sewage
  • eating shellfish taken from sewage-polluted areas, or eating raw fruits and vegetables which may have been fertilized with human waste
  • eating contaminated milk and milk products


All travellers to Pakistan are at risk of getting XDR typhoid fever.


If you are travelling to visit friends and relatives, you are at higher risk of getting typhoid fever than tourists and business travellers.


Travellers visiting family and friends are more likely to eat local food and be exposed to untreated water, which puts them at a greater risk for food and water-borne diseases.


Source: Canada: Typhoid in Pakistan