Typhoid Outbreak Alert? Doctors Reveal Why Cases Are Rising This Monsoon

Monsoon is the season when germs breed and multiply. As a result, vector- and water-borne diseases like dengue, malaria and typhoid spike in no time. Therefore, timely diagnosis and medical intervention are highly necessary.

Noticeably, typhoid made a recent resurgence with reports suggesting a spurt in the number of patients contracting the infectious illness. Incidentally, Cockroach Janata Party (CJP) founder-activist Abhijeet Dipke was diagnosed with typhoid last weekend amid his protest movement from Delhi’s Jantar Mantar venue (against an allegedly flawed education system with exam paper leaks) and was reportedly on IV (intravenous medication) drips.

Rampant rise

Doctors shed light on the sudden surge in the rate of typhoid cases lodged so far.

“Extensively drug-resistant (XDR) strains (e.g. the REPJPP01 lineage, which was first linked to Pakistan) that resist multiple antibiotic classes — leaving behind limited oral treatment options — have already spread internationally via travel. In some countries, the eruption happened even without any recent travel history,” informs Dr. Pankaj Khatana, senior consultant (internal medicine) from Marengo Asia Hospitals in Gurugram.

Further, shifting resistance patterns (e.g. declining multidrug resistance to older drugs in parts of India but persistent high fluoroquinolone resistance), sharp localised rises including cases reported in Indian cities with links to water scarcity or contamination, importations into non-endemic areas through trips or migration and incomplete/low vaccination coverage of typhoid conjugate vaccines (TCVs: advanced inoculations to prevent typhoid fever, a life-endangering bacterial infection) in many endemic settings despite their proven capacity to control the disease in eligible children are some of the other causes that could intensify the current situation.

“Typhoid is human-specific (no significant animal reservoir for S. Typhi: Salmonella Typhi is the bacterium responsible for typhoid fever, a condition indicated by high fever, stomach ache and weakness). Prevention hinges on safe water/food consumption, sanitation, hygiene and vaccination where risks are relatively high,” notes Dr. Khatana.

Dr Amit Saraf, director (internal medicine) at Jupiter Hospital in Thane agrees that typhoid is caused by the bacterium Salmonella enterica serotype Typhi, which spreads through adulterated food and water. “Infection usually occurs when a person consumes food or drinks tainted with the faeces/waste matter of an infected individual or carrier,” he concedes.

Studies reveal that poor sanitation, unsafe drinking water and inadequate hand hygiene remain the primary drivers of typhoid transmission, particularly in areas where access to clean water and proper sewage systems is minimal.

Monsoon malady

It’s true that people contract this disease more during the rainy season. Cases of typhoid and other enteric fevers commonly rise during and shortly after the muggy seasonal spells in monsoon-affected regions, especially in South Asia.

“Typhoid cases often increase in monsoons because heavy rainfall can pollute drinking water sources and heighten the dangers of food contamination. Waterlogging, flooding and poor drainage may force sewage to mix with the purified water supplies. Additionally, people tend to consume more junk food and beverages from outside at this time of the year, and if food hygiene is compromised with, then chances of infection loom large,” explains Dr Saraf.

Contagious syndrome

Typhoid is 100% infectious and spans through the faeco-oral route. In other words, the bacteria are shed in the stool and sometimes passed through urine of infected individuals. Virologists emphasise that if proper hand hygiene is not maintained after using the toilet or before preparing the daily meals, the bacteria can spread to others through soiled food, water or surfaces. Some individuals may also become chronic carriers, harbouring the bacteria without showing symptoms yet continuing to transmit the infection.

Symptoms

The usual trend is that typhoid develops gradually over several days. Common symptoms include relentless high fever, headache, weakness, fatigue, loss of appetite and abdominal discomfort. Some patients may experience constipation, while others develop diarrhoea. Nausea, vomiting and body aches may also occur. Medical experts warn that if left untreated, typhoid can lead to serious complications, such as intestinal bleeding or perforation, prompting early diagnosis and quick medical treatment.

Treatment

Typhoid is treated with appropriate antibiotics prescribed following clinical evaluation and on the back of blood culture or other laboratory investigations, whenever possible. “Completing the full course of antibiotics is vital — even if symptoms improve early — to prevent the relapse and reduce the risk of antibiotic resistance. Alongside medication, patients should maintain adequate hydration, consume a nutritious diet and get sufficient rest. Hospitalisation may be required in severe cases or if complications develop,” shares Dr Honey Savla, consultant internal medicine, Wockhardt Hospitals in Mumbai Central.

Vaccination

Vaccines are available to provide protection against typhoid, especially for individuals living in or travelling to high-risk areas. However, immunisation does not offer a foolproof defensive guard and should always be combined with safe food practices, clean drinking water and good personal hygiene. “Individuals should consult their physician regarding the most suitable shot of injection and the need for booster doses based on their risk profile,” instructs Dr Savla.

Soft Targets of Typhoid

People living in zones with poor wash infrastructure (urban slums, rural areas with filthy water and so on)

Tourists (particularly those visiting friends/relatives in endemic regions) and people dwelling in overcrowded or displaced settings

Individuals with reduced stomach acid (antacid use, etc. strip people off their primary chemical shield against ingested bacteria) or certain immunocompromising conditions

Seniors can face higher challenges in terms of aggravating complications in specific contexts like post-flood exposure, though classic endemic patterns show lower incidence in older adults owing to acquired immunity

Good news is that our domestic pets like cows, dogs and cats stay unharmed as animals are not prone to catch typhoid fever