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Malir locality suffers from outbreak of extensively drug resistant typhoid: Drug resistant typhoid claims two lives in Karachi

“Two young girls including 12-year old Shazadi and 9-year old Irum died due typhoid in the Sheedi Goth (village) of Malir District last week. Both the children had typhoid and died during treatment. The entire village is in the grip of typhoid and so far, we have taken samples of 122 people, mostly children for analysis”, said Dr. Ahmed Ali Memon, District Health Officer (DHO) Malir.

By M. Waqar Bhatti
June 26, 2019

Karachi: Health authorities are planning to launch a mass vaccination drive against typhoid fever in Karachi after two children died due to Extensively Drug Resistant (XDR) Typhoid in Sheedi Goth area of Malir district in Karachi this week, health officials said on Tuesday, adding as many as 122 cases of typhoid fever were reported from the area since June 18.

“Two young girls including 12-year old Shazadi and 9-year old Irum died due typhoid in the Sheedi Goth (village) of Malir District last week. Both the children had typhoid and died during treatment. The entire village is in the grip of typhoid and so far, we have taken samples of 122 people, mostly children for analysis”, said Dr. Ahmed Ali Memon, District Health Officer (DHO) Malir while talking to The News on Tuesday.

Several areas of Sindh are in the grip of the extensively drug-resistant (XDR) typhoid including Karachi, which authorities say, is rapidly getting out of control due to poor sanitary conditions, contaminated drinking water and lack of proper treatment facilities. According to unofficial figures, several dozen deaths were reported from different parts of the province from the superbug that is resistant to the most known antibiotics.

According to World Health Organization (WHO), the bacteria salmonella typhi causes typhoid fever, which is a life-threatening and a highly infectious illness that spread with poor sanitation. The circulating strain of XDR Salmonella entericaserovar Typhi in Pakistan is resistant to five classes of antibiotics thereby named as extensively drug resistant (XDR) Typhoid.

The WHO’s Infection Prevention Control (IPC) experts have declared anti-microbial resistance (AMR) and XDR typhoid as the most serious healthcare challenge for Pakistan as compared to HIV and Hepatitis B and C epidemics in the province, saying the anti microbial resistance could play havoc with the lives of people in Pakistan, if not managed at the earliest.

District Health Officer Malir said the outbreak in Sheedi village of Malir was first reported to them on June 18, 2019 when a young girl died due to typhoid fever and over 30 people, mostly children reported high-grade fever. Next day, another child from the same area died at National Institute of Child Health and doctors confirmed his death as a result of the lethal water-borne disease.

“We immediately sent an epidemiological team to the area, which examined the living conditions, took samples of water and also sent the blood samples of the sick children and patients for analysis. Initial reports suggest an outbreak of typhoid is the cause of two deaths and sickness of over 150 people in the area”, Dr. Ahmed Ali Memon said. He said the experts of Field Epidemiology and Laboratory Training Programme (FELTP) also examined a water tank from where villagers used to get water for drinking and they were shocked to learn that sewage mixed water was being consumed.

Confirming the deaths, Director General Health Sindh Dr. Masood Solangi said health department’s teams are responding to the outbreak of typhoid. He also confirmed that of the 51 typhoid cases, five were confirmed as XDR typhoid cases while results of several other cases were awaited. He added that in order to contain the epidemic, they have decided to immediately start a vaccination drive in the area.

“All the suspected cases tested positive for IgM antibodies on Rapid Diagnostic Testing. Moreover, 5 (10%) out of the 51 suspected cases tested positive for being extensively drug resistant strains on blood culture (resistant to ceftriaxone) and the rest 46 (90%) are awaiting their culture results”, Dr. Masood Solangi informed. Sharing the data of typhoid and XDR typhoid cases in the province since November 2016 till May 05, 2019, Dr. Solangi said a whopping 10,677 people were tested positive for typhoid in the province, of which 7,109 were infected with XDR typhoid.

“Of these, 7,947 cases of typhoid were reported from different areas of Karachi, of which 4,973 were XDR typhoid”, Dr. Masood Solangi said and added however, they do not have any actual data of deaths due to XDR typhoid in Sindh,” he added.

To a query, DG Health Sindh said a meeting of all the stakeholders including international health agencies representatives in Pakistan and health department officials is being held today (Wednesday) to immediately launch a vaccination drive in whole of Karachi.