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Drug-resistant typhoid is spreading in Pakistan: Here is what we know

MM News Staff by MM News Staff
September 24, 2024
Illustration of an antibiotic-resistant bacteria (white) on the colon epithelium. The antibiotic-resistant bacteria will go on to transfer its antibiotic resistance genes horizontally to the bacteria surrounding it. Photograph: Science Photo Library/Alamy

Illustration of an antibiotic-resistant bacteria (white) on the colon epithelium. The antibiotic-resistant bacteria will go on to transfer its antibiotic resistance genes horizontally to the bacteria surrounding it. Photograph: Science Photo Library/Alamy

As world leaders gather in New York to address the fight against superbugs, which could claim nearly 40 million lives by 2050, Pakistan’s children are already on the frontline, battling a rapidly spreading, drug-resistant strain of typhoid.

Typhoid, or enteric fever, is a life-threatening infection contracted from contaminated food or water. Left untreated, it has a fatality rate of one in five. Fortunately, a simple course of antibiotics typically cures it, and most people start recovering within days once treatment begins.

However, the antibiotics once used to treat typhoid are increasingly ineffective. The bacterium responsible, “Salmonella typhi”, has evolved resistance to these medications—a growing issue seen worldwide. Of the approximately 9 million typhoid infections each year, most now involve drug-resistant strains. Pakistan has the highest rates in South Asia, with over 15,000 officially reported cases of extensively drug-resistant (XDR) typhoid.

Typhoid risk is especially high in areas lacking access to safe water and sanitation. In Pakistan, one of the world’s lowest-ranked countries for clean water access, contaminated water is linked to roughly 80% of the nation’s diseases, exacerbated by failing sewage systems.

What is AMR?

Antimicrobial resistance (AMR) occurs when microorganisms—bacteria, viruses, fungi, and parasites—develop mechanisms to survive treatments that once killed them. These resistant pathogens, often called “superbugs,” pose a significant global health threat.

How did drug-resistant typhoid emerge?

Bacteria develop resistance through repeated exposure to antibiotics, and the more they encounter these drugs, the faster they adapt. Overuse of antibiotics is a key driver of this resistance. This week, world leaders are convening at the UN in New York to discuss solutions to drug-resistant infections and negotiate a political declaration among member states to tackle the growing AMR crisis.

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