I went to college at a small liberal arts school outside of Philadelphia that was founded in 1864. That same year, during the height of the American Civil War, Philadelphia was in the middle of a typhoid epidemic. During the civil war, 80,000 Union Soldiers died from dysentery and typhoid – more than the total number of Confederate Soldiers that were killed in action. In 1864 alone, more than 1 in every 1,000 people died of typhoid in Philadelphia. On an average year in the late 1800’s, the death rate for typhoid in Philadelphia was lower, but only about half that amount.
Typhoid is a bacterial disease spread by contaminated water and food that causes high, prolonged fever and, when not treated by antibiotics (which were not generally available until the 1930s) as much as 20% of people infected with typhoid die. In the 1890’s household water filtration was introduced and by 1909 the entire water supply to the city was filtered. After that time, death rates due to typhoid in Philadelphia plummeted.
Today, rates of typhoid fever incidence in cities in developing countries such as Karachi, Pakistan and Nairobi, Kenya are as high as that seen in Philadelphia in the 1800s. Today, we have antibiotics, but the bacteria have become increasingly resistant to the common, inexpensive antibiotics on the market. Water filtration or chlorination would solve the typhoid problem, as well as most diarrheal diseases, but 2.1 billion urban residents use facilities that do not safely dispose of human waste. Creating sanitation infrastructure and public services that work for everyone is a major challenge with a long time horizon. While we work with our partners to develop safe water, sanitation and hygiene solutions for everyone who needs them , we have to use our most powerful short-term weapon against typhoid: vaccines.
Schoolboy vaccinated for typhoid in Karachi Pakistan. Photo courtesy of International Vaccine Institute and the Pakistani Trust for Vaccines and Immunization
Typhoid vaccine usage and the simultaneous development of better typhoid vaccines are essential complements to the work we do in sanitation. We must continue our investments in typhoid vaccines and deliver them to those who need them most in order to prevent the spread of typhoid.
About 200,000 people die yearly from typhoid today, most of them children, and most of them in urban slums – no child in the 21st century should get, let alone die from typhoid. To quote Mia Farrow, “Wherever there is poverty, it is children who pay the highest price.” Typhoid is preventable – let’s act now to finally protect the children from this 19th century disease.
Vaccines preserve life and benefit entire societies across generations – but they must not be taken for granted. Today, one out of five children worldwide is left behind, unprotected against killer diseases. We must reach 100% of children with life-saving vaccines. Support UNICEF to help reach all kids with the vaccines they need.
To learn more about typhoid vaccines, visit The Coalition against Typhoid and The International Vaccine Institute.