Multi-drug Resistant Typhoid in Pakistan (Update 2)
17 Oct 2018
Health Protection Scotland (HPS) wish to remind travellers that an outbreak of extensively-drug resistant (XDR) typhoid continues in Pakistan: media reported on 16 October 2018 of an emergency meeting in Hyderabad to discuss preventive measures for XDR typhoid in Pakistan.
As reportedpreviously by the Centers for Disease Control and Prevention (CDC) the XDR typhoid outbreak originated in Hyderabad in 2016, subsequently spreading to Karachi and multiple districts of Sindh Province. As a result cases among travellers returning to the United Kingdom and the United States from Pakistan were reported in 2018.
Advice to travellers
Typhoid is spread by the faecal oral route, precautionary measures should therefore be taken to avoid consumption of potentially contaminated drinks, drinking water and ice and to ensure food is uncontaminated or cooked thoroughly.
Personal hygiene when eating and drinking is also important including hand washing prior to eating and using clean plates, cups and utensils.
When to consider vaccination
Vaccination is recommended for travellers to high risk areas where food and water may be contaminated.
Travel to low risk areas - vaccination may be recommended only to those staying in conditions with poor sanitation and unable to maintain their own hygiene precautions e.g. hand hygiene and water purification.
For further information see Typhoid.