Once again a preventable illness emerging from Pakistan has placed international health organisations including the WHO and the Centres for Disease Control and Prevention on high alert. This comes as a form of highly antibiotic-resistant typhoid has swept through Karachi and other parts of Sindh, affecting at least 8,000 people. This strain of typhoid does not respond to the drugs usually used to treat the infection and as a result cannot be contained. While local health experts believe at least a dozen people have already died, the Sindh Health Department is so far confirming only four deaths.
There is, however, no denying the fact that Pakistan has once again failed to rein in a potentially fatal illness. Typhoid is spread through contaminated water or food and brings on high-grade fever, weakness and stomach related complaints. In most cases, the correct antibiotic would control the sickness. But this particular strain, which was initially identified by the AKUH, is left untouched by these medications. There are few facilities in the country to carry out the testing required to identify what has become known as the XDR, or extremely drug resistant, form of typhoid. The WHO is working on a national health plan with local authorities to try and control the outbreak.
Pakistan’s struggles with disease are closely linked to its failure to provide safe water to its citizens or to adequately vaccinate those at risk from sickness. A vaccination against typhoid is available and under the present circumstances should naturally be widely used, especially among school-going children, with the infection reportedly spreading rapidly through schools, mainly through unsafe water sources. A campaign also needs to be run to educate doctors and make them more aware of the drug resistant nature of the new strain of typhoid. Those looking into the epidemic must also assess the impact of the misuse of antibiotics in the country and how this is contributing to the emergence of disease which fails to respond to these essential medications. The discovery of penicillin in 1928 had essentially altered the world of disease by making it possible to save lives by offering a pill or an injection to people stricken with a host of bacterial infections. Today, we seem to have turned back the clock. The fact that antibiotics, including fourth generation medications, do not work for the type of typhoid that has swept through Sindh means people are once again at risk as they were in the times before penicillin was introduced. Travel warnings about visits to Pakistan have already been issued by nations around the world and there is an obvious fear that the sickness will spread to beyond Pakistan’s borders.
