Typhoid fever continues to pose a serious public health threat in Kenya, driven by poor sanitation, rising medical costs, and weak enforcement of prevention measures.

Stakeholders have struggled to implement basic controls such as proper sewage systems, clean water access, and safe food handling practices turning what should be preventable outbreaks into recurring crises.

Currently, at least 25 counties are battling outbreaks, with experts warning that the lack of clean water, especially in informal settlements, is accelerating the disease’s spread.

The situation is further aggravated by a surge in illegal eateries operating without health oversight. Many food handlers in urban centres, including those in licensed establishments, lack up-to-date medical certificates or vaccinations.

"Public health officers must shut down unlicensed food vendors and strictly enforce vaccination for all food handlers,” said Narshibhai Ghedia, Managing Director at Kenya Laboratory Supply Centre.

Ghedia blamed corruption for the rampant issuance of fake health certificates and noted that some laboratories employ unqualified staff unaware of the risks posed by unvaccinated food servers.

Doctors across the country have raised alarm over the deteriorating situation, warning that immunization drives and public awareness campaigns often stall due to mismanagement.

A promising three-year typhoid education initiative in Nyanza was scrapped just nine months in due to internal wrangles over funding. Yet a later Kenya Medical Association (KMA) survey showed the campaign had reduced infections by 40 percent.

Medical experts stress that vaccination remains the most effective defense. Dr Mohan Lumba, a medical consultant, explained that typhoid symptoms have changed over time.

“We no longer see classic signs like high fever and slow pulse rate. The current strain often mimics malaria, with mild abdominal pain, fatigue and headaches,” he said. Misdiagnosis is common, especially in children, who suffer more severe symptoms due to weaker immunity.

Globally, typhoid kills over 600,000 people annually, according to the World Health Organization (WHO), most of them in low-income regions. In Kenya, an estimated 11 percent of the population is infected, with many cases going undetected due to inadequate data and underreporting.

The Ministry of Health, through the Social Health Authority (SHA), continues to promote immunization under its expanded programme. But uptake remains low in some areas, including Siaya County, where turnout during a recent campaign was described as dismal. “It’s a repeat of the Covid-19 vaccine skepticism,” said Ken Otieno of Kopiata Dispensary in Rarieda.

Dr Patrick Amoth, Director General at the Ministry of Health, emphasized the need to combine vaccination with hygiene awareness. “The typhoid conjugate vaccine offers protection for up to five years and is safe for children as young as a few months,” he said. “But it must go hand in hand with clean water, handwashing, and safe food preparation.”

Vaccination alone, experts caution, is not a silver bullet. Basic home practices boiling water, sanitizing raw fruits, and thoroughly washing vegetables remain essential to reduce infections, especially in urban slums where waterborne diseases thrive.

Ultimately, Kenya’s battle with typhoid underscores the urgent need for stronger public health enforcement, better community education, and political will to implement lasting solutions.