Typhoid fever may sound like a disease from history books, but it’s quietly staging a dangerous comeback, and this time, it’s evolving faster than our medicine can keep up.
Scientists are warning that the bacterium responsible for typhoid, Salmonella enterica serovar Typhi (S. Typhi), is rapidly developing resistance to nearly every antibiotic we rely on to treat it.
For decades, antibiotics kept typhoid under control. But that control is slipping.
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A major 2022 genomic study analyzed nearly 3,500 typhoid samples collected between 2014 and 2019 in Nepal, Bangladesh, Pakistan, and India. The results were alarming: extensively drug-resistant (XDR) strains are spreading quickly and replacing older, treatable strains.
These super strains are resistant to:
That leaves just one reliable oral antibiotic: azithromycin.
And even that last line of defense is beginning to crack.
Researchers have now identified mutations that reduce the effectiveness of azithromycin. If those mutations merge with already extensively drug-resistant strains, we could face virtually untreatable typhoid infections.
This isn’t just a regional issue. While South Asia remains the epicenter, accounting for roughly 70% of global cases, resistant strains have already spread internationally. Nearly 200 documented export events since 1990 have carried these superbugs to Southeast Asia, Africa, the UK, the US, and Canada.
Can’t believe we are still having Typhoid outbreak in 2026.
Typhoid spreads through food or water contaminated by infected person’s feces or urine.
USA- 350 typhoid fever cases/year
India- 4.9 million typhoid cases/yearWe are millions years behind in hygiene & public health.
— Anuradha Tiwari (@talk2anuradha) January 9, 2026
Untreated typhoid can kill up to 20% of those infected. In 2024 alone, more than 13 million cases were reported worldwide.
Health experts say vaccines may be the strongest tool left to prevent disaster. Typhoid conjugate vaccines have shown strong effectiveness, and countries like Pakistan have already introduced routine immunization programs.
The World Health Organization has prequalified four typhoid conjugate vaccines, and more endemic countries are beginning rollout.
But vaccination access remains uneven, and time may not be on our side.
Antibiotic resistance is already one of the leading causes of death globally, surpassing HIV/AIDS and malaria. Typhoid could soon become one of its most dangerous examples.
The warning from scientists is clear: If we don’t expand vaccination and invest in new treatments now, this ancient disease could spark a modern health crisis.
