Typhoid fever infection – Antibiotic resistance and vaccination strategies: A narrative review

Cristina Masuet-Aumatell, Jorge Atouguia

Research output: Contribution to journalReview articlepeer-review

9 Citations (Scopus)
39 Downloads (Pure)


Typhoid fever is a bacterial infection caused by the Gram-negative bacterium Salmonella enterica subspecies enterica serovar Typhi (S. Typhi), prevalent in many low- and middle-income countries. In high-income territories, typhoid fever is predominantly travel-related, consequent to travel in typhoid-endemic regions; however, data show that the level of typhoid vaccination in travellers is low. Successful management of typhoid fever using antibiotics is becoming increasingly difficult due to drug resistance; emerging resistance has spread geographically due to factors such as increasing travel connectivity, affecting those in endemic regions and travellers alike. This review provides an overview of: the epidemiology and diagnosis of typhoid fever; the emergence of drug-resistant typhoid strains in the endemic setting; drug resistance observed in travellers; vaccines currently available to prevent typhoid fever; vaccine recommendations for people living in typhoid-endemic regions; strategies for the introduction of typhoid vaccines and stakeholders in vaccination programmes; and travel recommendations for a selection of destinations with a medium or high incidence of typhoid fever.

Original languageEnglish
Article number101946
Number of pages15
JournalTravel Medicine and Infectious Disease
Publication statusPublished - 1 Mar 2021


  • Bacterial
  • Drug resistance
  • Risk
  • Salmonella typhi
  • Travel
  • Typhoid-paratyphoid vaccines


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