The Provincial Disease Surveillance and Response Unit (PDSRU) report states that as many as 17786 typhoid cases have been reported from November 2016 to May 2019 out of which 10677 are typical typhoid cases while 7109 are extensive drug resistance (XDR) typhoid. The resistance cases mostly reported from Karachi and Hyderabad.
Out of total 7109 XDR typhoid fever cases, 4973 were reported in Karachi, 1772 in Hyderabad, and 364 in other districts. This year, a total of 1626 XDR typhoid cases were detected across the Sindh province out which 1087 surfaced in Karachi, 386 in Hyderabad, and 153 in other districts.
The XDR Salmonella Typhi causes typhoid fever, a life-threatening and highly infectious illness that affects millions of people in the developing world and tends to spread in areas with poor sanitation. The risk of acquiring XDR typhoid in Pakistan is high because of insufficient access to clean water and poor sanitation and hygiene. The antibiotic-resistant Salmonella Typhi strains have become increasingly prevalent in recent decades.
The government has already begun a mass vaccination campaign in the Sindh province in response to the XDR typhoid outbreak. Approximately 210000 children aged 6 months to 10 years have received the typhoid vaccine or the typhoid conjugate vaccine in Hyderabad. The Sindh Government has also implemented water purification and sanitation activities, carried out the community and school awareness campaigns on safe hygiene and sanitation practices, and created a national XDR typhoid taskforce.
Health experts recommended an improvement in the water and sanitation situation in high risk districts, ensuring clean and safe water for drinking, mass awareness and health education, availability and use of chlorine tablets at household and community level, availability of blood test (culture and sensitivity) for detection, and the availability of typhoid conjugate vaccine.