http://www.digitaljournal.com/life/health/drug-resistant-strain-of-typhoid-spreading-worldwide/article/433025

Drug-resistant strain of typhoid spreading worldwide

Posted May 11, 2015 by Karen Graham
An antibiotic-resistant "superbug" strain of typhoid fever is spreading around the world at a rapid pace say health officials. The disease is driven by a single family of the bacteria, known as H58.
The H58 family is displacing other typhoid strains  and it has now reached Southern Africa.
The H58 family is displacing other typhoid strains, and it has now reached Southern Africa.
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In a study that involved 74 researchers in over 12 countries, it was found that the antibiotic-resistant typhoid, identified as being one family, H58, has spread globally.
Time reports that study author Kathryn Holt said in a statement: “Multidrug-resistant typhoid has been coming and going since the 1970s and is caused by the bacteria picking up novel antimicrobial resistance genes, which are usually lost when we switch to a new drug. In H58, these genes are becoming a stable part of the genome, which means multiple antibiotic-resistant typhoid is here to stay.”
Genome sequencing was performed on 1,832 samples of the Salmonella typhi bacteria, from 63 different countries, collected between 1992 and 2013. Researchers found that 48 percent of the samples were from the H58 family of typhoid bacteria.
The H58 strain apparently first emerged in South Asia about 30 years ago. It then spread on to Southeast Asia, Western Asia, East Africa and Fiji. It has now shown up in southern Africa.
Typhoid fever is spread by consuming food or water contaminated with fecal matter or urine of people infected with the bacteria. Symptoms include nausea, fever, abdominal pains, and pink spots on the chest. Untreated, it can lead to worsening abdominal problems and severe headaches. Untreated, it is fatal in 20 percent of the cases.
Vaccines for typhoid are available, but due to lack of cost effectiveness in poorer countries, is not widely used. While "regular" strains of typhoid are treatable with commonly used antibiotics, the new superbug-strain is resistant to these antibiotics, making it a very dangerous pathogen.
Vanessa Wong of Britain's Wellcome Trust Sanger Institute, and a member of the research team, said that worldwide, 30 million people are infected with typhoid fever annually. In the U.S., an estimated 5,700 people come down with typhoid fever every year, usually after traveling abroad.
Wong mentions that good and detailed surveillance is needed worldwide in order to keep track of and contain any further outbreaks of this strain of typhoid. It is worrisome that the H58 strain has reached Southern Africa. With West African nations just now trying to come back from the devastating Ebola outbreak, the prospects of an outbreak of Typhoid fever is something to watch closely.
The international study was published in the journal Nature Genetics on May 11, 2015. The title of the paper is: Phylogeographical analysis of the dominant multidrug-resistant H58 clade of Salmonella Typhi identifies inter- and intracontinental transmission events