The Health Department in Sindh has admitted the provincial government has no action plan to prevent the spread of the extensively drug-resistant (XDR) strain of typhoid fever in the province.
According to Minister of Sindh for Health Dr Azra Fazal Pechuho, the Health Department is still waiting for the federal government to arrange vaccines for XDR typhoid, as the province battles the outbreak caused by a superbug that is resistant to most known antibiotics.
The XDR typhoid outbreak, since it was reported from Hyderabad in November 2016, has spread to Karachi and other cities and town in Sindh, and has claimed four lives, Dr Azra Pechuho said.
She admitted that the provincial government has no strategy in place to counter the disease, and is at the mercy of the federal government to acquire the vaccine for the treatment of the strain.
The minister said the Health Department has asked the local governments to improve the chlorination in water supplies, as the disease has spread due to the lack of sanitation and presence of open garbage dumps in Karachi and other places.
More than 5,000 children affected have been affected by this typhoid strain, she added.
The World Health Organisation has declared the XDR typhoid, which is caused by antimicrobial resistant (AMR) strains of Salmonella enterica serovar Typhi (or S. Typhi), as a notable public health concern.
According to the global health body, 5,274 cases of XDR typhoid out of 8,188 typhoid fever cases were reported by the Provincial Disease Surveillance and Response Unit (PDSRU) in Sindh from November 1, 2016 through December 9, 2018.
Sixty-nine percent of cases were reported in Karachi, 27 percent in Hyderabad district, and four percent in other districts in the province.
WHO recommends typhoid vaccination in response to confirmed outbreaks of typhoid fever. Where the TCV is licensed, it recommends TCV as the preferred typhoid vaccine.
Typhoid vaccination should be implemented in combination with other efforts to control the disease.
Currently, azithromycin is the only remaining affordable first-line oral therapeutic option to manage patients with XDR typhoid in low-resource settings, according to the health body.
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