A waterborne typhoid fever outbreak sickened more than 20 people in China earlier this year.

The outbreak involved 23 patients in an apartment in Changping District in Beijing and was caused by extensively drug-resistant (XDR) Salmonella Typhi through a polluted water supply.

It was the first report of a waterborne outbreak caused by XDR Salmonella Typhi in the country, according to a study published in China CDC Weekly.

In early February, four clinically diagnosed typhoid cases were reported by health officials. Of the 23 sick people, illness onset date ranged from Jan. 22 to Feb. 13, with the peak on Feb. 4. Eight cases were male and all were adults, with an age range between 22 and 45, and median of 30 years old. They had diverse occupations, but none worked in the food sector. Symptoms mainly included a high fever and diarrhea.

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