Cases of typhoid fever rising at alarming rate.

PESHAWAR -- Health experts have said that unsanitary conditions, lack of proper waste disposal, contamination of water by sewage, shortage of clean drinking water and public ignorance are main causes of rise in cases of typhoid fever.

'We will go 100 years back when typhoid would kill 40 per cent of the infected people. It used to be the case prior to invention of antibiotic but now despite of so many antibiotics we would be left with no effective antibiotic against the disease,' Prof Mohammad Noor Wazir of Hayatabad Medical Complex told Dawn.

According to him, more than 40 cases have been detected during the last few months only in one ward of the hospital. All the cases have extensively drug resistant (XDR) salmonella isolated from their blood. The superbug is only sensitive to costly antibiotics including Meropenem, Azithromycin and Imipenem.

Salmonella was once easy to treat with simple antibiotics like Septran, Ampicillin and Chloramphenicol. With the passing of time and use of haphazard antibiotics without any prescription by the people themselves, the organism became resistant even to Ceftriaxone and Fluroquinolones. 'Now we have reached to a stage that it responds to Meropenem, Imipenem and Azithromycin. The average cost of treating one case with these antibiotics is almost Rs100,000,' said Prof Noor.

Experts call for public health measures to control situation

Physicians at the local hospitals say that they have written several letters to the directorate-general health services to issue directives to the public health section to take concrete steps for controlling the situation. Without public health measures like vaccination, sewage disposal, availability of safe drinking water, public awareness on print electronic and social media and monitoring hotels, restaurants and sellers of cold beverages in the bazaars, the situation can't be controlled, they add.

It is strange that government has established culture facilities at the public health laboratory in Khyber Medical University Peshawar where there is no patient flow. These facilities should be available at the doorsteps as most of the doctors are sending tests to Shaukat Khanum, which is inconvenient and very expensive.

Prof Khalid Mahmood, a former physician at Lady Reading Hospital, said the ailment was endemic in that part of...