You are correct. From wikipedia:
Factors outside the household, such as unclean food from street vendors and flooding, help distribute the disease from person to person.[11] Because of poverty and poor hygiene and insanitary conditions, the disease is more common in less-industrialized countries, principally owing to the problem of unsafe drinking water, inadequate sewage disposal, and flooding.[15] Occasionally causing epidemics, paratyphoid fever is found in large parts of Asia, Africa, Central and South America. Many of those infected get the disease in Asian countries. About 16 million cases occur a year, which result in about 25,000 deaths worldwide.[16]
The very definition of a “shithole”.
IOW, post #8 is spot-on.