Growing Health Burden of Salmonella Infections in India

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Key takeaways

A Lancet study estimated 4.9 million typhoid cases in India in 2023, highlighting the growing threat of Salmonella infections and rising antimicrobial resistance.
Typhoidal Salmonella spreads through contaminated food and water, while Non-typhoidal Salmonella (NTS) moves through an animal-food-environment chain involving poultry and meat.
High resistance against fluoroquinolones antibiotics in Salmonella Typhi is making regular medical treatment increasingly ineffective.
The WHO recommends administering typhoid conjugate vaccines (TCV) starting from six months of age to prevent severe infection.
Containing widespread Salmonella transmission requires an integrated One Health approach that addresses human, animal, and environmental factors together.

A recent Lancet study estimated around 4.9 million typhoid cases in India in 2023, pointing to a significant burden of undiagnosed non-typhoidal Salmonella infections and growing antimicrobial resistance.

Salmonellosis is a bacterial infection caused by Salmonella bacteria that affects the intestinal tract of humans and animals.
Typhoidal Salmonella causes typhoid and paratyphoid enteric fever through strains like Salmonella Typhi and Salmonella Paratyphi, whereas Non-typhoidal Salmonella (NTS) mainly triggers gastroenteritis and severe bloodstream infections in vulnerable patients.
Most non-typhoidal Salmonella infections remain untested and unrecorded because mild cases usually resolve on their own without hospitalization or medical testing.

Typhoid primarily spreads through food and drinking water contaminated with human faeces, while NTS follows a complex transmission chain involving poultry, eggs, meat, and polluted surroundings.
Patients infected with Salmonella typically experience prolonged fever, abdominal pain, diarrhoea, nausea, and vomiting, while severe cases can lead to dangerous intestinal bleeding or tissue perforation.

Performing a blood culture test before administering antibiotics serves as the primary diagnostic tool for confirming suspected typhoid cases.
Effective prevention requires safe drinking water, proper sanitation, hand hygiene, thorough cooking of meat and eggs, correct refrigeration, and avoiding kitchen cross-contamination.
The WHO recommends giving typhoid conjugate vaccines (TCV) to children starting from six months of age to build long-term immunity.

The efficacy of standard treatments is declining rapidly due to rising antimicrobial resistance (AMR) against fluoroquinolones antibiotics in Salmonella Typhi bacteria.

Controlling non-typhoidal Salmonella requires an integrated One Health approach that unites human health, animal husbandry, logistics, and kitchen safety practices.