Outbreak of Extremely Drug-Resistant Typhoid in Southern Pakistan

A robust strain of the bacterium is spreading in vulnerable neighborhoods because of poor sewage and water systems

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Feces-contaminated food or water have created a big typhoid epidemic in Pakistan, with more than 500,000 people contracting the disease every year. Some strains of the disease-causing bacterium have become increasingly resistant to antibiotics, according to a Scientific American article. Now, southern Pakistan is in the throes of the world’s first outbreak of XDR (extremely drug resistant) typhoid, caused by a bacterial strain that only responds to one class of antibiotics. Infectious disease experts believe that the main drivers of the disease’s spread are Pakistan’s feeble sewage and water systems that are vulnerable to contamination—in poor neighborhoods sewage lines are rare, and those that exist are often broken. Efforts are underway to vaccinate children under the age of five in the most vulnerable neighborhoods with a new typhoid vaccine, but are hindered by distrust among some Pakistani people who believe the vaccines are a foreign plan to poison them. Meanwhile, researchers are trying to understand how the typhoid bacterium became so drug-resistant, and found that it likely developed its resistance with the help of DNA from another microbe such as Escherichia coli

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