Pakistan approaches Indian firm to buy vaccine against XDR typhoid

Pakistani health authorities have approached an Indian vaccine manufacturer, Bharat Biotech International Limited, for the supply of typhoid conjugate vaccine to contain the Extensively Drug Resistant (XDR) typhoid, which has claimed over a dozen lives in Sindh alone and has become highly endemic in the province, especially in Karachi, health officials said.

Bharat Biotech International Limited is the only manufacturer of the typhoid conjugate vaccine that is sold under the brand name “Typbar TCV” and it is the world’s first clinically proven conjugate typhoid vaccine.

According to the manufacturer, Typbar TCV is the only approved vaccine for children and infants less than two years of age. The XDR typhoid is a multi-drug resistant strain of typhoid fever that is resistant to 3rd generation Cephalosporin antibiotics and, currently, the entire Sindh province is in the grip of lethal, water-borne disease that is caused by Salmonella Typhi that is spread through contaminated food and water.

High-grade fever, weakness, stomach pain, nausea, headache, cough and loss of appetite are some of the symptoms, while some people may have diarrhea or constipation. In rare cases, typhoid fever can be fatal. Treatment with antibiotics is essential. Vaccination helps to protect people from getting typhoid fever.

“The federal government has approached the Indian vaccine manufacturer through the GAVI Alliance to provide us the typhoid conjugate vaccine, which is the only vaccine prequalified by the World Health Organisation (WHO) to prevent XDR typhoid,” Sindh Health Minister Dr Azra Pechuho told journalists in Karachi on Tuesday.

Talking to reporters after an event at Shaheed Mohtarma Benazir Bhutto Trauma Centre, she said she was not aware of the actual number of deaths due to the XDR typhoid in Sindh since its outbreak in November 2016, she rejected claims that the provincial health department was hiding facts and figures regarding the fever from the people and the media.

She maintained that the Indian manufacturer had assured it would supply the vaccine in batches but its full consignment would be received in October 2019, after which it would be supplied to the provinces as per their needs.

Sindh health department authorities said they along with Aga Khan University officials had launched a vaccination drive against the XDR typhoid in the Latifabad and Qasimabad towns of Hyderabad as well as in the Lyari Town of Karachi, but due to a limited number of vaccine doses, very few children could be vaccinated against the disease, which is now becoming a global health challenge as travellers might carry the disease to other parts of the world.

The gravity of the situation could be gauged from the fact that all major international health organisations, including WHO, Center for Disease Control (CDC) Atlanta, United States, GAVI Alliance that helps in procurement and provision of vaccines, and other American and European institutions, were helping Pakistan contain this outbreak, the health officials said.

“Once the full consignment of the typhoid conjugate vaccine is received by Pakistan from India, it would be included in the EPI (Expanded Program on Immunisation) Program, at least in the Sindh province,” an official said, adding that a massive drive would be launched by the end of this year on the pattern of the polio campaign to vaccinate a maximum number of children against this lethal water-borne disease.

What to do for prevention?

“People should drink safe (boiled) water, avoid ice of unknown purity while they should wash fruits, vegetables and utensils with boiled water before eating, using,” said Secretary General Pakistan Medical Association (PMA) Dr Qaiser Sajjad while responding to the threat of the XDR typhoid in the province.

“Everybody should wash their hands with soap before eating, after going to toilet, and people should avoid eating from eateries outside. In case of any disease or emergency, they should only visit qualified doctors and medical practitioners. Self-medication should also be avoided while Hakeem/homeopaths and other health providers should not prescribe antibiotics,” he added.