Cases of imported typhoid fever reach record high in Britain
Imported cases of typhoid fever have reached a record annual high in Britain, driven in part by the spread of a drug-resistant variant of the disease in Pakistan.
At least 702 imported cases of typhoid and paratyphoid fever, bacterial infections which can kill one in five if left untreated, were detected in 2024, according to data from the UK Health Security Agency.
The UKHSA did not say how many people had died as a result of the diseases, which typically causes fever, headache, fatigue and muscle ache, but can also lead to severe complications including internal bleeding in the digestive system.
The figures represent an eight per cent increase on the year before and the highest number recorded annually in modern times.
The vast majority of cases found in the UK are acquired in South Asia, in countries with poor sanitation and limited access to clean water – including India, Bangladesh, and Pakistan, which have the highest rates of typhoid globally.
The disease is caused by Salmonella bacteria which spreads through contaminated food or water. Paratyphoid fever, a close cousin of typhoid, is caused by a different strain of Salmonella and can be harder to treat.
Cases of typhoid have increased worldwide over the last decade, due in large part to the rise of antibiotic-resistance – where bacteria develops the ability to resist the medicine used to treat them because of repeated exposure.
In Pakistan, a mutant strain of typhoid known as the XDR variant emerged and began to spread in 2016. It is resistant to almost all forms of treatment.
Of the roughly nine million people who contract typhoid each year globally, the vast majority are now infected by a drug-resistant strain.
While there is a typhoid vaccine, those at high risk of contracting the disease typically require a booster every three years to fight off the disease – something that can be difficult to get in low-income countries with weaker healthcare systems.
While most cases are now contacted abroad, typhoid was once a major public health issue in Britain, killing roughly 16,000 people every year in the 1800s.
The disease affected not only those in overcrowded slums and workhouses, but also in palaces – Prince Albert died of typhoid fever at the age of 42.
It is also not the first time Typhoid has crossed international borders – one of the most famous victims of the disease was an Irish cook, Mary Mallon, who infected hundreds of people on her emigration to America.
As an asymptomatic carrier of the disease, she unknowingly infected – and killed – swathes of people she worked alongside in domestic households on America's East Coast, as well as the wealthy families she cooked for.
The cook was eventually forced into quarantine by authorities, where she remained for 26 years until her death.
The term 'typhoid Mary' is now synonymous with the spread of the disease.
To prevent infection when travelling abroad, the UKHSA recommends washing your hands before eating and taking care to avoid unsafe water supplies. They also recommend vaccination, which is available at all GP surgeries.
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