Multi-drug Resistant Typhoid in Pakistan (Update 1)
16 Apr 2018
Media 
report that an outbreak of multidrug resistant typhoid continues to spread in Pakistan. According to the National Institute of Health Islamabad, at least 850 people have been infected in 14 districts since 2016. Typhoid is endemic in Pakistan, although the current drug resistant form of Salmonella typhi is likely to have originated in Hyderabad, Sindh Province.
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.