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November 21, 2019

Unicef lauds Pakistan for taking XDR typhoid vaccination decision


November 21, 2019

The United Nations International Children’s Emergency Fund (Unicef) has congratulated and supported Pakistan’s federal and Sindh government for taking the bold step of vaccinating millions of children against XDR typhoid and said the vaccine against the disease is absolutely safe and an effective tool to protect children against the waterborne disease.

“We applaud the commitment of the Government of Pakistan and Sindh authorities for prioritising the health of children. The country is the first to immunise 10 million children aged nine months to 15 years old, starting in Sindh. UNICEF fully endorses the Typhoid Conjugate Vaccine (TCV), a safe and efficient way to protect children against this deadly disease,” Unicef Country Representative in Pakistan Aida Girma said in a statement on Wednesday.

“As we celebrate World Children’s Day today, let us remember that we need to ensure that every child has access to every right, starting with the right to health. Let’s protect children together by making sure they are all vaccinated in the coming two weeks,” the Unicef official said.

Up to 60,000 cases

The expected number of children affected bu extensively drug-resistant (XDR) typhoid is more than 50,000 in Sindh although, as per official figures based on blood culture for typhoid, only 14,054 children have been found affected till November 4, 2019, health officials said on Wednesday.

“As per our estimates, the number of children affected by XDR typhoid in Sindh could be between 50,000 and 60,000 as in many cases we clinically diagnose patient and considering it a case of drug-resistant typhoid start its treatment,” said Prof Jamal Raza, the director of the National Institute of Child Health (NICH), while talking to The News.

An emergency vaccination drive against the XDR typhoid has been underway in Sindh for the last three days to contain the epidemic after cases of the new type of typhoid were not only found in other provinces of Pakistan but also in seven countries of the world, compelling international health agencies to declare the outbreak as an international health emergency.

Authorities in Karachi said they had managed to vaccinate 2.7 million children in Karachi during the first three days of campaign, which intended to reach 5.2 million children to give them shots of Typhoid Conjugate Vaccine (TCV) despite the fact that some elements with vested interests tried to create confusion about the vaccine and spread baseless rumours.

Prof Raza said two cities of Sindh, Karachi and Hyderabad, were facing an epidemic of XDR typhoid, which had become a cause of concern internationally as this type of the waterborne disease was now only treatable with one antibiotic, which was extremely costly and required hospitalisation of the patient to a proper and well-equipped health facility.

“People are asking why we are asking for vaccination when typhoid cases are being reported for centuries in this region. It is because this new type of typhoid is a drug-resistant disease, and if the last drug against it fails, millions would die due to this treatable and preventable disease. Instead of waiting for the disease, we asked the government to import its vaccine and start vaccinating children so as to prevent them from catching this lethal disease,” he added.

He maintained that in most of the cases, pediatricians and experts of infectious diseases do not wait for the blood-culture report of a patient, whose symptoms indicate that he or she is infected with typhoid and is not responding to normal antibiotics.

He said that often such patients are admitted and given the last line of antibiotic, Carbapenem, which is the only treatment available against XDR typhoid.

To a query, Prof Raza said that in addition to vaccination, people should consume clean and boiled drinking water, avoid eating rotten food and should adopt the practice of hand-washing, especially after using the toilet.

He added that cleanliness was the first precautionary measure against the typhoid and other infectious diseases.

Another health expert, Dr Zeeshan Ansari, an expert of blood-borne disease and pathogens, said blood culture is the gold standard of diagnosing typhoid and XDR typhoid, but in many cases even blood culture gives the false negative result although the symptoms of patients indicate that they are infected with lethal bacterium.

He said that in many cases, XDR cases are diagnosed clinically and on the basis of symptoms without awaiting results of the blood-culture and added that number of XDR typhoid could be much higher than the official figures as many hospitals and laboratories don’t even report these cases to the health department.