Typhoid fever is an invasive bacterial disease caused by Salmonella enterica subsp. enterica serovar Typhi, characterized by bloodstream involvement [1]. It is transmitted by the faecal-oral route and produces a systemic illness [1].
Disease overview
Bacterial Evidence-backed information EN 6/7 applicable sections · ZH 6/7 applicable sections Updated Oct 23, 2026
Typhoid fever is an invasive bacterial illness linked to bloodstream infection that imposes a substantial health burden across Africa and Asia [1]. It predominantly affects people from infancy through young adulthood [1]. Since 2017, notable advances have been achieved in characterizing its global burden, understanding pathogenesis, and deploying vaccination programmes in high-incidence settings [1].
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After crossing the intestinal epithelium and spreading to systemic and intracellular sites, the organism produces an undifferentiated febrile illness [1]. Blood culture serves as the practical reference standard for confirmation where available, though newer diagnostic approaches are under active investigation [1].
Typhoid fever generates a high disease burden in Africa and Asia and mainly affects infants through young adults [1]. Genomic surveillance of 13,000 Typhi isolates shows genotype 4.3.1 (H58) remains confined to Asia and Eastern/Southern Africa, while other regions harbor distinct genotypes with independent antimicrobial resistance evolution [2]. Ciprofloxacin non-susceptibility is widespread globally, high-level ciprofloxacin resistance reaches about 20% in South Asia, and extensively drug-resistant typhoid dominates in Pakistan (70% in 2020) but is not yet established elsewhere [2].
The causative organism is passed via the faecal-oral route, traversing the intestinal epithelium to disseminate systemically [1].
Strategic multipartner collaboration and targeted clinical trials have advanced effective vaccination programmes in multiple high-incidence priority settings since 2017 [1].
GlobalID source-data note: German ‘Typhus’ and ‘Typhus abdominalis’ mean typhoid fever, not rickettsial typhus. Country series may be typhoid-only, paratyphoid-only, or a reported combined enteric-fever total; retain the source label before comparing or aggregating them.
- 1 Meiring JE et al. Typhoid fever. Nat Rev Dis Primers. 2023 Dec 14. PMID: 38097589. doi: 10.1038/s41572-023-00480-z. PubMed: https://pubmed.ncbi.nlm.nih.gov/38097589/
- 2 Carey ME et al. Global diversity and antimicrobial resistance of typhoid fever pathogens: Insights from a meta-analysis of 13,000 Salmonella Typhi genomes. Elife. 2023 Sep 12. PMID: 37697804. doi: 10.7554/eLife.85867. PubMed: https://pubmed.ncbi.nlm.nih.gov/37697804/
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