Typhoid fever is not the kind of illness most people in developed nations worry about. It's often written off as a disease of the past—something that plagued ancient societies before clean water systems and antibiotics. But here’s the thing: typhoid never went away. And now, it's evolving into something much more dangerous—something even modern medicine might not be able to stop.

A large genomic study published in The Lancet Microbe in 2022 has sounded the alarm. The bacterium responsible for typhoid, Salmonella enterica serovar Typhi (or S. Typhi), is rapidly acquiring resistance to nearly all antibiotics used to treat it. More disturbingly, strains resistant to multiple drug classes are spreading beyond their traditional strongholds in South Asia and appearing across continents—including in the United States, United Kingdom, and Canada.

This is no longer a regional concern. It’s a global one.

What is Super Typhoid?

The study involved sequencing over 3,400 S. Typhi strains collected between 2014 and 2019 from patients in India, Pakistan, Nepal, and Bangladesh. The results were stark. Not only were extensively drug-resistant (XDR) strains of typhoid rising rapidly, but they were also outcompeting and replacing less resistant versions.

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XDR typhoid strains are already immune to several older antibiotics—ampicillin, chloramphenicol, and trimethoprim/sulfamethoxazole. But here’s where it gets worse: many are now developing resistance to newer and more potent drugs like fluoroquinolones and third-generation cephalosporins, which until recently were mainstays of typhoid treatment.

Even the last reliable oral antibiotic—azithromycin—is showing signs of failure. The study found emerging mutations that could potentially render azithromycin ineffective. These haven’t yet converged with XDR strains, but scientists warn that it’s only a matter of time. If that happens, oral treatment options could become entirely obsolete.

For now, South Asia remains the epicenter of the crisis, accounting for about 70% of the global typhoid burden. But this doesn’t mean the threat is contained.

Researchers tracked nearly 200 instances of international transmission since the 1990s, most involving travel or migration. Typhoid "superbugs" have been detected in Southeast Asia, East and Southern Africa, and in wealthy nations where the disease was thought to be virtually eradicated.

“The speed at which highly-resistant strains of S. Typhi have emerged and spread is a real cause for concern,” said Dr. Jason Andrews, an infectious disease specialist at Stanford University who co-authored the study.

Why Is Treatment Is Failing?

If antibiotics are failing, what’s next? For starters, prevention. Experts say the most immediate and scalable solution lies in typhoid conjugate vaccines (TCVs). These vaccines offer strong, long-lasting protection and are safe for children as young as six months old. But access is patchy.

Pakistan became the first country to introduce TCV into its national immunization program in 2019—an urgent response to the first major outbreak of XDR typhoid that hit its population. Since then, the move has become a case study in how vaccination can cut off the disease at its roots.

India, Bangladesh, and Nepal have followed suit with pilot programs and localized rollouts, but global coverage remains far too low. Meanwhile, high-income countries have not prioritized TCV access at all, largely because typhoid isn’t seen as a domestic threat.

Antibiotic Resistance Crisis at Large

This typhoid crisis isn’t an isolated story. It’s part of a larger, systemic problem: antibiotic resistance is now one of the top global causes of death. A 2019 study published in The Lancet estimated that antimicrobial resistance was directly responsible for 1.27 million deaths worldwide, surpassing HIV/AIDS and malaria.

Typhoid is just the latest face of that threat. If azithromycin fails, intravenous treatments will be the only remaining option. This is not sustainable for low-resource settings, where typhoid is most rampant.

And as the S. Typhi genome continues to adapt, the search for novel antibiotics becomes more urgent but the global antibiotic pipeline is worryingly dry. Very few new drugs are being developed, and those that are rarely target neglected tropical diseases like typhoid.

How Globalization Makes It Everyone’s Problem?

COVID-19 reminded us how quickly a localized health threat can go global. Typhoid is no different. The bacteria travel with people—through tourism, immigration, and international trade.

The difference is: we already have tools to stop this. TCVs work. Better sanitation and access to clean water help. Public health messaging and travel guidelines can make a difference. But we’re not moving fast enough.

A recent Indian study estimated that vaccinating children in urban areas could reduce typhoid cases and deaths by up to 36 percent. That’s a significant dent—especially when combined with infrastructure upgrades and careful antibiotic stewardship.

What Happens If We Do Nothing?

If left unchecked, drug-resistant typhoid could become nearly impossible to treat in outpatient settings. That means more hospitalizations, more strain on health systems, more deaths—particularly among children in developing nations.

With around 11 million cases of typhoid annually, even a small increase in resistance could tip the balance into a major health crisis.

And if XDR strains gain resistance to azithromycin, we will be left with zero effective oral drugs, none. The path forward is clear—and urgent. Here’s what needs to happen:

• Expand global access to typhoid conjugate vaccines, especially in endemic regions.
• Invest in next-generation antibiotics that target typhoid and other neglected infections.
• Implement stricter regulations on antibiotic use in agriculture and medicine.
• Strengthen global surveillance systems to detect resistant strains early and contain outbreaks.
• Raise awareness that typhoid is not just a problem for the developing world.

Antibiotic resistance isn’t science fiction. It’s a biological reality. And typhoid is just one example of how quickly things can unravel when we underestimate an ancient enemy.

We can still turn the tide but only if we act with urgency and coordination. The warning signs are flashing red. Typhoid isn’t gone. It’s evolving. And this time, it may be deadlier than ever.

Weight loss drugs appeal to many for their convenience, but according to some experts, there are a number of noteworthy side effects. From rapid weight gain to sagging skin, several side effects of weight loss drugs have been identified through studies. Now, new research has found that weight loss drugs can cause more muscle loss than clinical expectations. The results, presented at the American College of Physicians Internal Medicine (ACP-IM) meeting in San Francisco, add to existing evidence on the possible adverse effects of GLP-1.

Why does muscle loss occur during weight loss?

When a person loses a considerable amount of weight, they also lose bone mass, muscle mass, and some connective tissue. Experts at the University of North Carolina at Chapel Hill found that no studies directly associate muscle loss with a decline in physical function or strength. However, this clinical gap underscores the need to assess strength and mobility alongside weight loss in patients receiving this therapy. The systematic review identified 36 randomised clinical trials that measured changes in muscle mass and fat among adults using incretin-based obesity medications such as tirzepatide, dulaglutide, or semaglutide.

Each study measured body composition using MRI, CT scans, and bioelectrical impedance analysis. Most of them used DEXA along with other methods to obtain information about lean muscle mass, bone mineral density, and the distribution of body fat. The average age of participants ranged from 20 to 63.7 years. Only four studies included participants aged 60 years and above. None of the studies focused on adults aged 65 years or older.

Average muscle loss on weight loss drugs

Researchers noted a concerning trend: patients’ estimated muscle loss exceeded the 25 per cent threshold. Clinicians had expected a 25 per cent reduction, but not more than that. Experts also found that 68 per cent of people who used the drugs exceeded the 25 per cent benchmark, compared to 50 per cent of those who relied on placebos and lifestyle interventions. None of the studies measured whether the loss of muscle mass was correlated with function or strength loss.

Muscle mass diminishes with age

Despite being a concerning side effect of weight loss drugs, muscle mass is likely to diminish anyway with age. Additionally, the loss is more significant in older adults. Therefore, doctors advise caution when prescribing these drugs to individuals who are more prone to losing muscle function at an advanced age. Ideally, doctors should recommend exercise or physical therapy to patients taking weight loss medications.

The final word

According to experts, weight loss drugs do have a positive side — and that extends beyond obesity treatment. These drugs are also beneficial for diabetes and help reduce the risk of cardiovascular disease. However, it is important to support treatment with the right kind of diet and a proper exercise regimen. Solely depending on the medication can lead to weight gain once it is discontinued. Therefore, for healthy weight loss, it is best to rely on sustainable methods for long-lasting results.

Indian guru and founder of the Isha Foundation, Sadhguru, offers a different perspective on life and mental health. In a 2025 talk, he spoke about weight loss. At a time when obesity, metabolic, and lifestyle disorders are at an all-time high, there is an urgent need to revisit and fix the way one eats. While many turn to diet fads and practise calorie or food group restrictions, Sadhguru recommends the contrary. The 68-year-old emphasises the importance of sustainable weight management through balanced choices, mindful eating and meals aligned with the body’s natural rhythm.

Sustainable approach to weight loss

Many people aim to lose weight to deal with body image issues or to prepare for a special upcoming occasion. However, according to Sadhguru, one must not try to force discipline through restriction, but instead allow the body to regulate itself efficiently while maintaining energy levels. If you are looking for foods to include in your diet for sustainable weight loss, here are some recommendations:

1. Plant-based diet: A plant-based diet is one of the most talked-about ways to lose weight sustainably. Nutritionists say that 30–40 per cent of the diet should consist of fruits, vegetables, whole grains and legumes. These foods are comparatively easier to digest and do not put much pressure on the digestive system, as opposed to heavy, non-vegetarian meals. This should be combined with a proper workout routine, as without movement, weight gain is likely to occur.
2. Eat millets: Millets such as ragi, bajra and jowar digest slowly. They have a low glycaemic index and do not cause sudden blood sugar fluctuations. A sudden rise and fall in energy levels can trigger sluggishness over time. Millets, on the other hand, release energy slowly, thereby keeping you active for longer and reducing frequent hunger pangs. Over time, you can reduce portion sizes to lose weight.
3. Occasional cleansing: During the talk, Sadhguru also emphasised the importance of periodic cleansing. Simple yet effective, periodic cleansing involves drinking a detox beverage such as ash gourd juice with a small amount of honey for one or two days a month. This acts as a gentle reset for the digestive system and helps the body feel refreshed and lighter. Over time, this can curb cravings and make fasting easier.
4. Sustainable rules: For weight loss, it is advisable to follow sustainable rules that are not too strict to maintain in the long run. For instance, fasting for long durations without giving your body enough time to adapt can lead to metabolic disorders over time and excessive hunger pangs. It is important to prioritise balance, awareness and nourishment.
5. Energy-boosting snacks: When hunger pangs occur, it is important not to turn to unhealthy snacks such as crisps, biscuits or tea cakes. Instead, for sustained energy, healthier snacks are recommended. Some of the best options include peanuts, berries, nuts and seeds. These will help you feel full and may even aid metabolism.
6. Time your meals: Timing your meals is equally important, as it gives the digestive system enough time to function. Ideally, there should be an eight-hour gap between meals. People who find this difficult can aim for a five- to six-hour interval instead. Frequent meals can place too much load on the digestive system, while infrequent meals can cause metabolic disturbances. Therefore, striking a balance is essential.

Eat healthy meals and follow a proper diet plan; your diet must be balanced—many have grown up listening to these healthy recommendations. However, little do we realise just how much difference healthy habits make to our lives. Even when it comes to constipation, one barely understands the long-term repercussions of irregular trips to the loo and how this may impact overall health. According to a 2023 review, prominent differences can be noticed in the gut microbiomes of 'slowpokes' and 'speeders.' Because the gut is strongly linked to overall health, there are several health implications that often go unnoticed.

What happens when you are constipated for a long time?

Constipation refers to a state wherein one fails to pass stools at least three times a week. Slow transit, too, is associated with inflammatory and metabolic disorders—and even Parkinson’s disease. Experts say that identifying microbiome profiles linked to gut transit time could help develop a fresh approach to treating and managing these conditions. Experts involved in the study explained how bidirectional interactions between transit time and gut microbiota provide a useful way to understand gut microbiome variations in both disease and health.

Why is the gut microbiome important?

Experts say that the gut microbiome, in both activity and composition, plays a crucial role in health. From diet to exercise, it can be shaped by various factors. For this, experts evaluated the impact of holding in stool and its consequent effects on health. They analysed previously published research on gut transit time, diet, gut microbiome composition, stool consistency, and metabolites released. Experts found that the studies involved thousands of participants—both healthy individuals and those dealing with comorbidities such as liver cirrhosis, irritable bowel syndrome and constipation. However, this required swallowable capsules with sensors to track their journey through the digestive tract.

Another method used was the Bristol Stool Scale—a diagnostic tool that classifies stool based on whether it resembles hard pellets or watery mush. Some studies also tracked how long participants took to pass sweetcorn or blue dye. The goal was the same — estimating how long food remains in the colon. The longer it stays, the more time bacteria have to regulate gut acidity, ferment components, and produce metabolites that influence overall health.

The nutrition link

The research team yielded interesting results — people with faster gut transit had different microbiomes compared to those with slower transit times. This helped provide better predictions for gut microbiota than a simple test alone. It was also found that faster gut transit times were associated with microbiomes dominated by faster-growing species that thrived on a low-fat, high-carbohydrate diet. Slower transit times, however, were linked to microbiomes influenced by diets high in protein. These extremes can reduce gut microbiome diversity compared to average transit times. Therefore, both fast and slow movement create environments where specific species dominate.

Collectively, the research showed that gut transit time is an overlooked tool for understanding how the gut functions, its role in overall health, and how people respond to treatments such as probiotics. This could also explain why the same gut health advice does not work for everyone. Two people can consume the same meal and still show different results, suggesting that an individual's gut rhythm can help tailor dietary advice and treatment to suit their body.

The research is published in the journal Gut.