In 2016, a large outbreak of extensively drug-resistant (XDR) Salmonella Typhi infections began in Sindh province, Pakistan, and spread throughout the country. The strains (kinds) of Typhi linked to the outbreak do not respond to most antibiotics used to treat typhoid fever. Some people linked to the outbreak have died. Several countries (including the United States) have reported XDR typhoid fever among people who traveled to and returned from Pakistan.
In the United States, public health officials have increased efforts to quickly interview and test samples from patients who may have typhoid fever.