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Antibiotic resistant typhoid has been known to be in existence since the 1970’s, but it is now more prevalent in certain countries than the standard typhoid. The main areas affected are parts of Asia and Africa, and this particular strain is called H58. To understand why this is such a problem, you need to know what typhoid is and what the relevance of the antibiotic resistance is.
What Is Typhoid Fever?
Usually just referred to as typhoid, this disease is caused by bacteria called Salmonella Typhi. It is spread from person to person through consuming water or food that has been contaminated by the feces of an infected person. This could be due to the simple act of not washing one’s hands after using the bathroom. This disease is typically found in areas where there is very poor sanitation and poverty.
It can take up to thirty days to develop the illness post exposure, and the symptoms can vary from mild to severe, and in some cases, the disease can prove fatal. The most common symptoms include high fever, weakness, constipation, abdominal pain, headaches and a skin rash. These symptoms may last for a matter of days, or even months, without treatment. It is possible to carry the infection without becoming infected as well.
Many developed countries provide a vaccine against typhoid, which is successful in 50-70 percent of cases. It is generally recommended for those that are traveling to countries that have a high risk of typhoid. There have been reported cases in countries such as the US, but the most highly affected country is India.
The usual treatment for typhoid is antibiotics, including those such as cephalosporins, azithromycin and fluoroquinolones, but H58 is proving much more difficult to treat because it has become resistant to many antibiotics. This resistance is also known as multi-drug resistance, and greatly affects the treatment and outcome of the disease.
In this case, it is believed that the over-prescription of antibiotics has led to the bacteria picking up antimicrobial resistance genes. With around a third of the population of the world being at risk, this has a massive impact on how the disease can be treated.
Antibiotic resistance typhoid is continuing to evolve, so each time a new drug is initiated, it acquires new gene mutations. The H58 strain was first acknowledged more than 20 years ago in South Asia. Researchers found that it then spread to Western Asia, Southeast Asia, East and South Africa and the island nation of Fiji. By studying the genetic sequencing, they have been able to track the spread of each strain as it appears in each location.