Extensively drug-resistant typhoid in Pakistan

Level 1 - Practise health precautions (more details)

Original publication date: January 30, 2019

Updated: June 24, 2022

Current situation

There is an ongoing outbreak of extensively drug-resistant  typhoid fever in Pakistan that does not respond to most antibiotics. Cases were first reported in Hyderabad and the city of Karachi, but the outbreak has now spread to other parts of the country. Canada and several other countries have reported cases of extensively drug-resistant typhoid fever in travellers returning from Pakistan.

About typhoid

Typhoid fever is an illness that is caused by a type of Salmonella bacteria called Salmonella typhi. Extensively drug-resistant typhoid is resistant to at least five different antibiotic classes.

Typhoid fever can be spread to humans through:

  • eating food or drinking beverages that have been handled by a person who is infected with typhoid fever
  • drinking water that has been contaminated with sewage
  • eating shellfish taken from sewage-polluted areas, or eating raw fruits and vegetables which may have been fertilized with human waste
  • eating contaminated milk and milk products

All travellers to Pakistan are at risk of getting extensively drug-resistant typhoid fever. 

If you are travelling to visit friends and relatives, you are at higher risk of getting typhoid fever than tourists and business travellers. Travellers visiting family and friends are more likely to eat local food and be exposed to untreated water, which puts them at a greater risk for food and water-borne diseases.


Consult a health care professional or visit a travel health clinic at least 6 weeks before you travel.

Before your trip

  • Get vaccinated
    • There is a vaccine that protects against typhoid fever.
    • Discuss the benefits of getting vaccinated with a health care professional before travelling.

During your trip

  • Eat and drink safely
  • Wash your hands often
    • Use soap and warm running water, and wash for at least 20 seconds
    • Wash your hands before eating or preparing food and after using the bathroom or changing diapers
    • Use alcohol-based hand sanitizer only if soap and water are not available. It’s a good idea to always keep some with you when you travel.

Monitor your symptoms

  • If you develop symptoms similar to typhoid fever during your trip or after your return, see a health care professional and tell them where you have been travelling or living.

Registration of Canadians Abroad

Sign up with the Registration of Canadians Abroad service to stay connected with the Government of Canada in case of an emergency abroad or an emergency at home.

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