XDR typhoid presents new dilemma for citizens

KARACHI: Health officials of the Sindh Health Department and UNICEF have expressed serious concerns over the increasing number of 'extensively-drug resistant' (XDR) typhoid cases in the province.

Typhoid infects around 21.6 million people every year, while the severity of the disease kills two to six thousand people each year. In Asia, Pakistan and India are mostly affected by the infection.

The provincial health department will launch a Typhoid Conjugate Vaccine (TCV) campaign against XDR typhoid fever from the 18th to 30th November 2019 to target around 10 million people of Sindh, the officials said and urged the citizens to adopt simple hand hygiene, and avoid eating unhealthy food.

Antibiotic resistance has become a significant issue in the treatment of typhoid, while there are a few limited antibiotic options available for the treatment of typhoid, they said, adding that as many as 4,709 typhoid cases were registered in Sindh during August 2019, while out of the total 2,999 cases have been reported in Karachi only.

Dr Zahoor Ahmed Baloch, former Project Director EPI (Expanded Program on Immunization), Dr Khalid Zubairi and Suneel Raja, Provincial C4D Consultant – EPI, expressed these views while speaking at the public awareness seminar held at the Prof Salimuzzaman Siddiqui Auditorium, organized by the Dr Panjwani Center for Molecular Medicine and Drug Research (PCMD), University of Karachi.

The Dr Panjwani Center, Sindh Health Department, and Virtual Education Project Pakistan (VEPP) jointly organized the seminar.

Delivering a presentation on this fatal disease, Dr Khalid Zubairi pointed out that as many as 10,000 people had been infected from the typhoid fever in Sindh so far. He said the use of contaminated water was the primary cause of typhoid fever, which is an acute illness associated with fever caused by the Salmonella enterica serotype Typhi bacteria.

It can also be caused by Salmonella paratyphi, a related bacterium that usually results in less severe symptoms, he said. As a major step towards the eradication of typhoid, the protection and purification of drinking water supplies must be ensured. Improvement in basic sanitation and promotion of food hygiene are the major steps to eliminate this disease from Sindh.

He pointed out that typhoid fever was a fundamental cause of morbidity and mortality in low-income and middle-income countries.

Dr Zahoor Ahmed Baloch pointed out that the typhoid outbreak in Hyderabad and Karachi had prompted the need for the TCV vaccine in Sindh. He said that the TCV Catch-up campaign had been planned to target 10.1 million children under 15 years of age (9 months to 15 years). The total of the target population included 4.7 million from Karachi alone, he said.

Suneel Raja said that the vaccination for XDR typhoid fever has also been added to the expanded program on immunization and that the typhoid conjugate vaccine was currently not available commercially.

The society needs to join hands with the government to fight against typhoid and other fatal diseases and infections that have become prevalent in the country, he said.