Efforts to fight typhoid in some of the world's poorest countries have helped create an antibiotic-resistant "superbug" strain of the disease that's spreading worldwide, researchers warn. According to a study published in Nature Genetics, the resistant H58 strain of typhoid is now present in at least 21 countries, mainly in Africa and Asia, where it has displaced older and more easily treated forms of the bacteria, the BBC reports. The researchers, who looked at bacteria samples collected from 63 countries over more than 20 years, warn that H58 is "completely transforming the genetic architecture of the disease and creating a previously under-appreciated and ongoing epidemic," Reuters reports.
The researchers say the H58 strain started to spread from South Asia around 30 years ago and is making it much tougher for doctors to treat typhoid, which is spread through contaminated food and water and kills around 200,000 people a year. In countries where typhoid is endemic, vaccines aren't widely used but "antibiotics are commonly used as a preventive measure. As a consequence, there is a rise in antibiotic resistance to many pathogens and in particular a resurgence of multidrug-resistant typhoid," study author Vanessa Wong tells CBS, which notes that while Americans are at little risk from the disease at home, experts recommend they be vaccinated before traveling to at-risk areas. (Liberia is now Ebola-free—but it's experiencing a related surge in measles cases.)