Doctors are worried that an extensively drug-resistant strain of typhoid fever that is causing an epidemic in Pakistan may spread to other countries.
“The typhoid strain, resistant to five types of antibiotics, is expected to disseminate globally, replacing weaker strains where they are endemic. Experts have identified only one remaining oral antibiotic — azithromycin — to combat it; one more genetic mutation could make typhoid untreatable in some areas,” reports Emily Baumgaertner in the The New York Times.
About 17 million people worldwide experience typhoid fever every year and kids between 5 and 12 years old are the most affected.
It was in November 2016 when the outbreak was seen in the Sindh province of Pakistan suspected to have been caused by contaminated water sources due to leaking sewage pipes. Local doctors started to worry when cases were unresponsive to ceftriaxone, an antibiotic used to treat multidrug-resistant strains of typhoid.
At least 850 people were reported to have contracted the extensively drug-resistant strain, which has led to four deaths. “Antibiotic resistance is a threat to all of modern medicine — and the scary part is, we’re out of options,” Dr. Rumina Hasan, a pathology professor at the Aga Khan University in Pakistan, tells The New York Times.
Typhoid fever occurs when a person eats or drinks food that's contaminated by urine or feces, says WHO. Symptoms include high fever, severe headache, and loss of appetite. Younger children may also present with diarrhea. Severe disease can cause delirium, shock, and intestinal perforation or hemorrhage. Treatment includes “antibiotic therapy, fever-lowering agents such as paracetamol, and management of fluid status.”
washing vegetables and fruits and cooking food all the way through
practicing good hand washing habits, especially after using the toilet and before eating
avoiding eating street food
Note that the routine use of typhoid vaccines is not recommended as per WHO. In the 2018 childhood immunization schedule for Filipino children, the vaccine is only recommended for high risk groups such as children with compromised immune systems.
Doctors are treating the typhoid strain in Pakistan with more expensive treatments that must be administered in the hospital, The New York Times reports. “Once we aren’t able to treat this effectively, we’re going back to the pre-antibiotic era. That would mean a lot of fatalities in our future,” Dr. Elizabeth Klemm, an infectious disease geneticist, told the publication.
Antibiotic resistance happens when bacteria change in such a way that it can now protect itself from a drug or neutralize an antibiotic. Being antibiotic resistant, “infections became more difficult to treat, we have to use agents that are more toxic and more expensive, and we have to use them longer,” says Dr. Arjun Srinivasan, associate director of infection prevention programs of the Centers for Disease Control and Prevention (CDC).
Each person can also contribute to the prevention of antibiotic-resistant diseases through the appropriate and proper use of antibiotics often called antibiotic stewardship. Practice antibiotic stewardship by following these steps:
Only take antibiotics when prescribed by a doctor. Remember that viral infections cannot be treated with antibiotics. Do not insist on antibiotics when a doctor has not prescribed it.
Take the appropriate daily dosage. Always take the full prescription even if you or your child are already feeling better. If you forget a dose, ask your doctor what you should do.
If for some reason you have leftover antibiotics, throw them away. In the same light, do not take leftover antibiotics for a later illness.