How to Prevent Typhoid Fever in Pakistan

Typhoid fever is caused by bacteria called Salmonella Typhi. It is common in South Asia, and Pakistan faces a particular challenge: a strain of typhoid that many antibiotics no longer work against. That makes prevention more important than ever.

How does typhoid spread?

An infected person passes the bacteria in their stool. Others catch it by eating or drinking something contaminated, for example:

• Drinking unsafe water, or ice made from it
• Eating food washed in contaminated water
• Eating food handled by someone who did not wash their hands after using the toilet

Some people carry the bacteria in their gut even after they recover, and can still spread it.

What are the symptoms of typhoid?

• High fever that lasts for days, often 39 to 40°C (103 to 104°F)
• Weakness and tiredness
• Headache
• Stomach pain
• Constipation or diarrhoea
• Nausea, loss of appetite or cough
• Sometimes a rash of flat, rose-coloured spots

What is XDR typhoid?

XDR stands for "extensively drug-resistant". According to WHO, an XDR typhoid outbreak began in Sindh in November 2016 and infected more than 10,000 people, mostly in Sindh province. It was the first typhoid outbreak ever reported that resisted the standard treatment used worldwide, as well as all but one antibiotic taken by mouth. When medicines stop working, typhoid becomes much harder to treat and more dangerous.

The typhoid conjugate vaccine (TCV)

In November 2019, Pakistan became the first country to add the typhoid conjugate vaccine to its routine immunisation programme. Key facts from WHO:

• A campaign in urban Sindh aimed to vaccinate about 10 million children aged 9 months to 15 years.
• In routine immunisation, TCV is given from 9 months of age.
• TCV is a single injected dose and can be given from 6 months of age.

Ask your nearest vaccination centre or health worker whether your child is up to date.

How to prevent typhoid at home

• Drink safe water. Boil it if you are unsure, and avoid ice unless it is made from safe water.
• Eat food that is well cooked and still hot.
• Drink only boiled or pasteurised milk.
• Wash fruit and vegetables with safe water, and peel them when you can.
• Wash your hands with soap, especially after using the toilet, changing nappies and before cooking or eating.

When to see a doctor

Typhoid can be life-threatening. See a doctor promptly if you or your child have a fever lasting more than three days and feel very unwell, especially with stomach pain or weakness. Do not treat yourself with leftover medicines. If antibiotics are prescribed, take them exactly as directed for the full course, and go back to the doctor if you still feel ill afterwards. Until your doctor says it is safe, do not cook or serve food for others. If someone with typhoid becomes very ill, get emergency help or call Rescue 1122.