Why the deadly typhoid outbreak in Sudan could spill over to Kenya

 

A medical practitioner prepares a vaccination dose during a nationwide vaccination campaign to administer both the Measles-Rubella (MR) and Typhoid Conjugate Vaccine (TCV) to children aged 9 months to 14 years being administered at Mutuini Sub-County Hospital on July 16, 2025. [Kanyiri Wahito, Standard]

Neighbouring South Sudan and Sudan have been experiencing severe cases of the deadly disease, typhoid fever. From Port Sudan on the Red Sea to the capital, Khartoum, the number of cases is alarmingly high.

The disease could easily spread to Kenya given the significant cross-border movements between the three countries. It must also be remembered that the world is now a global village. A report by the International Committee of the Red Cross states that the disease is killing people mercilessly, much like the ongoing civil conflict.

Medics operating between Khartoum and Port Sudan have been overwhelmed. The fighting in South Sudan and Sudan has left the countries extremely vulnerable, as doctors lack the necessary technology and resources to prevent the spread of the disease. Most foreign doctors have also left due to the ongoing factional wars.

An official from the International Committee of the Red Cross, who requested anonymity, stated that the disease has claimed about 5,000 lives since the war began in Sudan two years ago.

Urgent appeal

“The international community and the World Health Organisation (WHO) need to send a committed team of humanitarian and medical personnel, as well as equipment, drugs, and vaccines, to intervene and save lives,” said the Red Cross official.

Typhoid fever is caused by contaminated water and food.

“It is, therefore, paramount that effective public health interventions, such as improved environmental management and adequate pharmacological measures, are implemented to control the disease among vulnerable populations, not only in Sudan but also in Kenya,” said Professor Charles Chunge, Director of the Centre for Travel and Communicable Diseases.

In Kenya, typhoid fever continues to cause suffering in various parts of the country, with occasional deaths reported in Nyanza, Coast, North Eastern, Rift Valley, Western, Central, and Nairobi regions.

The disease is easy to prevent and control if effective measures are in place. The WHO estimates global deaths from typhoid fever at 600,000 annually, the majority in developing countries. According to Professor Chunge, former chairman of the Typhoid Advisory Committee, the death toll may be underestimated due to inadequate health data in many developing countries.

Transmission facts

He explains that the disease infects around eight per cent of the population in affected areas, with some victims dying if prompt treatment is not administered. “Typhoid fever is transmitted through unclean water and contaminated food and drinks. It is more common among the poor, particularly those living in densely populated communities under unhygienic conditions,” said Professor Chunge.

The disease is especially prevalent among young children in poorer regions due to lower hygiene standards. In slums, where poverty is widespread, poor housing, uncontrolled sewage disposal, and broken water pipes mixing with sewage are common. Children, by virtue of their age, often ingest soil or other contaminants.

Considering the high cost of treatment with strong antibiotics, experts stress prevention, including immunisation and home-based control measures, such as clean water, safe food, and a hygienic environment.

The government has officially included the typhoid conjugate vaccine (TCV) alongside other childhood vaccines. TCV is now provided free at all public health facilities during routine vaccination campaigns, targeting children aged nine months to 14 years under the Kenya Expanded Programme on Immunisation (KEPI), confirmed Dr Patrick Amoth, Director General of Medical Services.

High-risk groups

However, Prof Chunge challenges the government to remind county public health officers to make typhoid vaccination mandatory, especially for high-risk groups such as hotel and restaurant staff.

“Those working in food service constitute a larger reservoir for typhoid spread, and this group requires mandatory immunisation to reduce transmission,” he said.

Experts note that classical typhoid symptoms, include diarrhoea, vomiting, high fever, and prostration. However, slow pulse is rarely observed today due to bacterial antigenic shifts or mutations.

Medical experts, including Dr Mercy Njuguna and Dr Wycliffe Mbaya, say that in Kenya, the disease now commonly presents as a mild illness with abdominal discomfort, fatigue, slight headache, body aches, and fever.

Proper diagnosis

“Because the symptoms resemble mild malaria, many patients self-treat for malaria first. This highlights the importance of proper medical testing before taking any medication,” advised Prof Chunge.

“Buying drugs based on internet research can have serious medical consequences, as a physician must evaluate your condition before prescribing treatment,” experts warn.

Professor Chunge adds that symptoms are more pronounced in children. Treating typhoid with drugs is more expensive than immunisation, which is feasible and provides immunity lasting six years. Food service workers must be immunised every six years and possess valid certification.

The cost of treating typhoid in Kenya varies significantly depending on whether it is outpatient or inpatient care. Outpatient treatment ranges from Sh500 to Sh38,000, while hospitalisation can reach Sh140,000. Typhoid conjugate vaccines sold by private pharmacies cost between Sh2,000 and Sh3,500.