Why CDC is Involved with Global Typhoid Fever

Updated April 1, 2022

Health Costs: The Typhoid Fever Burden is Highest Among Children

In 2017, over 10 million typhoid fever cases occurred globally, causing over 116,000 deathsexternal icon. Children are at highest risk for severe illness and death from typhoid fever with more than 50% of typhoid fever cases and deaths occurring in children less than 15 years old.

Monetary Costs: The Economic Burden of Typhoid Fever is High for Patients

A woman holds young boy recovering from typhoid fever at a healthcare facility in Bangladesh, 2016.

A young boy recovering from typhoid fever with his mother at a hospital in Bangladesh, 2016. Credit: Sabin Vaccine Institute/Das.

The Surveillance for Enteric Fever (typhoid fever and paratyphoid fever) in Asia Project was a multi-country, multi-site population-based surveillance study aimed at characterizing the burden of enteric fever in South Asia. The project showed how typhoid fever created economic hardships for patients, especially when compared to what they might normally spend on healthcare. The median cost of the illness (treatment associated costs and time lost from work or school) for study participants who were not hospitalized was about $39 in Nepalexternal icon, $45 in Bangladeshexternal icon, and $157 in Pakistanexternal icon, as much as or more than a person in those countries might spend on medical care over an entire year ($49 in Nepal, $37 in Bangladesh, and $43 in Pakistan).

Ongoing Challenges: The Need for Typhoid Fever Vaccines is Growing

Although improvements in water and sanitation are essential to preventing typhoid fever, vaccines are increasingly becoming more necessary, as multidrug resistant strains of S. Typhi (the bacterium that causes typhoid fever) have been emerging since the 1980s. Multidrug resistant strains mean that some antibiotics are not an effective treatment. Fully resistant strains to fluoroquinolones (a group of antibiotics) are common in South Asia and sub-Saharan Africa. Strains resistant to other antibiotics are starting to emerge.

Growing antibiotic resistance makes the need for vaccines even greater. Typhoid conjugate vaccines (TCV)external icon prevent typhoid fever, which could help decrease the use of antibiotics and may limit the emergence of new S. Typhi drug resistant strains. TCV also protect infants and children against typhoid fever for 5 years or longer.

In 2018, The World Health Organization (WHO) recommended external iconthat in countries where typhoid fever is endemic (local transmission) or causes recurrent outbreaks, TCV be included in childhood vaccination programs and administered at 9 months of age or up to 2 years of age. Catch-up campaigns for children up to 15 years of age are also recommended at the time of TCV introduction in those countries. By the end of 2021, TCV had been introduced into the childhood vaccination program in four countries: Liberia, Pakistan, Samoa, and Zimbabwe.

Actions: CDC Works to Support TCV Activities Worldwide

CDC works with partners to support TCV activities worldwide to help control typhoid.

Page last reviewed: March 22, 2022
Content source: Global Immunization