All Travelers to Pakistan At Risk of Getting Drug Resistant Typhoid Fever

MedicalResearch.com Interview with:

Kevin Chatham-Stephens, MD, MPH, FAAP CDR U.S. Public Health Service

Dr. Chatham-Stephens

Kevin Chatham-Stephens, MD, MPH, FAAP
CDR U.S. Public Health Service

MedicalResearch.com: What is the background for this study?

Response: Typhoid fever is a life-threatening disease caused by Salmonella Typhi bacteria. It spreads when someone consumes food or water that has been contaminated with feces (poop) from someone carrying the bacteria. About 12–27 million cases of typhoid fever occur worldwide every year.

About 350 culture-confirmed cases of typhoid fever in the United States are reported to CDC each year. Most of these cases occur among international travelers.

Symptoms of typhoid fever often include high fever, weakness, stomach pain, cough, and loss of appetite. Some people have diarrhea or constipation. Typhoid fever can be prevented through vaccination and safe food and water practices. Typhoid fever is treated with antibiotics, although most infections diagnosed in the United States cannot be successfully treated with the class of antibiotics called fluoroquinolones.

MedicalResearch.com: What are the main findings? 

This photograph depicts a dorsal view of a house fly, Musca domestica, and was created during a 1972 study of disease carriers, and pests of migrant labor camps. Annoying houseflies may spread typhoid, cholera, dysentery and diarrhea. They can carry these disease causing organisms from garbage, sewage and fecal matter to food, or to a person's hands or lips.

House Fly
This photograph depicts a dorsal view of a house fly, Musca domestica, and was created during a 1972 study of disease carriers, and pests of migrant labor camps. Annoying houseflies may spread typhoid, cholera, dysentery and diarrhea. They can carry these disease causing organisms from garbage, sewage and fecal matter to food, or to a person’s hands or lips.

Response: Healthcare providers should advise patients who are traveling to South Asia to get a typhoid fever vaccine at least 2 weeks before leaving and to select food and water carefully while traveling internationally. Healthcare providers should consider typhoid fever in sick patients who have recently traveled to or from Pakistan. Patients with travel to Pakistan should be treated with azithromycin for uncomplicated typhoid fever and carbapenems for complicated disease.

All travelers to Pakistan are at risk of getting extensively drug-resistant typhoid fever. Travelers to South Asia, including Pakistan, India, and Bangladesh, should take precautions to protect themselves from typhoid fever. Visit your doctor or a travel clinic at least 2 weeks before travel to get vaccinated against typhoid fever. Always follow safe food and water guidelines during

Citation:

Chatham-Stephens K, Medalla F, Hughes M, et al. Emergence of Extensively Drug-Resistant Salmonella Typhi Infections Among Travelers to or from Pakistan — United States, 2016–2018. MMWR Morb Mortal Wkly Rep 2019;68:11–13. DOI: http://dx.doi.org/10.15585/mmwr.mm6801a3.

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