Super typhoid threat looms: experts raise alarm

A concerning rise in super typhoid cases is being reported across the metropolis, with medical experts attributing the surge to widespread misuse of antibiotics, which has weakened people's immune systems and led to the emergence of drug-resistant bacteria. According to physicians, oral medications are now ineffective against this strain, and treatment depends solely on specific antibiotics administered intravenously.

General physician at Jinnah Hospital Karachi Dr Faisal Javed shared these insights during a conversation with The Express Tribune. He revealed that the number of super typhoid cases is steadily increasing, and the extensively drug-resistant (XDR) variant exhibits a dangerously high resistance to commonly used antibiotics. He warned that case numbers are expected to rise further after Eidul Azha.

Typhoid is caused by the Salmonella Typhi bacterium, which spreads through contaminated water, unhygienic utensils, and substandard food - conditions prevalent in areas with poor sanitation infrastructure.

"In Pakistan, the rampant and incorrect use of antibiotics has led to the development of XDR or 'super typhoid,' a strain that no longer responds to most standard medications," Dr Faisal said. "Only specific and often expensive IV antibiotics are proving effective."

He expressed concern over the role of unqualified practitioners and under-equipped laboratories, which frequently prescribe medications based on unreliable tests like "Typhi Dot" or stool analysis. These tests can yield false positives, particularly if a patient has previously been exposed to the bacteria, leading to misdiagnosis and inappropriate treatment.

According to Dr Faisal, a blood culture test is the only reliable method for diagnosing super typhoid. Although it takes about seven days to deliver results, it remains the most accurate way to determine effective treatment.

Symptoms of typhoid include high fever, abdominal pain, constipation or diarrhea, gas, and body aches. The XDR strain tends to cause more severe symptoms. If left untreated, the bacteria can impact vital organs including the liver, brain, stomach, and bone marrow - posing a serious threat to life. In some cases, patients may deteriorate before accurate diagnosis is possible, making recovery more difficult.

Dr Faisal recommended that patients eat easily digestible foods like Khichdi (a soft mixture of rice and lentils), yogurt, boiled vegetables, and fruits to help the body heal. He also urged the government and food safety authorities to enforce stricter hygiene standards among restaurants and street vendors, many of whom use contaminated water to wash utensils, aiding in the spread of the disease. Public awareness campaigns should emphasise handwashing before meals and after using the toilet as essential preventive measures.