(Reuters) – Pakistan began vaccinating millions of typhoid children on Friday to try to control a drug-resistant drug fever outbreak that has infected about 11,000 people since 2016 and is at risk of spreading internationally.
The immunization campaign, using a recently developed vaccine to prevent typhoid infection for up to five years, begins in the southern province of Sindh and targets children between 9 months and 15 years, officials said.
By 2021, it will become a national program and part of routine child immunization schedules.
"Initiation of vaccination in urban areas is critical to preventing disease among the most at-risk communities," Azra Fazal Pechuho, Sindh's provincial health minister, said in a statement. Typhoid also disproportionately affects children.
Typhoid fever is caused by Salmonella Typhi bacteria and spreads through contaminated food and water. It causes fever, nausea, stomach pain and pink spots on the chest and in severe cases can lead to life-threatening bowel and head complications.
A Global Burden of Disease study by the American Institute of Health Metrics and Assessment estimates that in 2017 there were 11 million typhoid cases and 116,000 typhoid deaths worldwide.
The outbreak of typhoid fever in Pakistan is caused by a bacterial strain that has evolved extensive drug resistance and has become a so-called “superbug”. It started in 2016 and has so far infected about 11,000 people, with a mortality rate of about 1%.
The strain is resistant to everyone except an antibiotic used to treat typhoid fever. If resistance to this final antibiotic treatment develops, disease experts say, mortality rates among those infected can rise dramatically to as much as 20 percent.
The new typhoid vaccine was approved in 2018 by the World Health Organization. Its launch is funded by the Geneva-based GAVI alliance, an agency supported by the Bill & Melinda Gates Foundation, WHO, the World Bank, UNICEF and others, organizing mass purchasing to reduce vaccine costs for poor countries.
"This was a terrifying disease in the past," GAVI chief executive Seth Berkley said in a telephone interview. "(E) the rise of extreme risks of drug-resistant typhoid, bringing us back to levels of mortality never seen since the 19th century – posing a risk to us all."
Cases of travelers have already been spread to Pakistan from the United States, Australia, Britain, Canada, Denmark and Taiwan, who brought the disease to their home countries.
Kate Kelland's report in London; Editing by Peter Graff