It’s hard to realize that typhoid in Pakistan can impact us, but it’s much more likely than we may like. There’s an epidemic in 14 districts there, some 850 cases of typhoid which have been spreading since 2016. The problem is that the particular strain is mostly resistant to five different kinds of antibiotics. And further that strain is expected to disseminate globally. An oral antibiotic azythromycin is hoped to help, the last to be tried. If it fails, typhoid could be untreatable. So the issue is no longer about typhoid, but about antibiotic resistance. That means as far as typhoid is concerned we would have to return to the pre antibiotic era, and that would involve a very high mortality rate. As it is 21 million people suffer from typhoid each year and 161,000 already die of it. A hope for containing this epidemic lies in a vaccination campaign—indirectly making the case for the importance of vaccination.
The whole issue of antibiotic resistance is far from new which makes what’s going on in Pakistan more than a wake-up call. It is also an intractable problem since it affects the entire food chain. Cattle, for example, are fed antibiotics are as a means to prevent them from contracting certain diseases. The result is that even if we don’t take antibiotics ourselves we ingest them if or when we eat meat from such cattle. While the dangers of antibiotic resistance have been too abstract for us to grapple with and comprehend something like the typhoid epidemic in Pakistan brings them home in a way we can’t avoid and too one we must remember.