Karachi is facing an alarming spike in “super typhoid” cases, with health professionals warning of a fast-growing, drug-resistant form of the disease that is proving increasingly difficult to treat.
The rise in cases comes amid mounting concerns about antibiotic misuse, inadequate hygiene, and unreliable diagnostic practices.
Dr Faisal Javed, a general physician at Jinnah Hospital, highlighted the severity of the situation, noting that “the number of super typhoid cases is steadily increasing” and this extensively drug-resistant (XDR) variant has developed an “alarmingly high resistance” to standard antibiotics.
The bacteria behind typhoid, Salmonella Typhi, are commonly spread through unclean water, poorly washed utensils, and unhygienic food, all of which are prevalent in areas with substandard sanitation. What makes this wave more dangerous, experts say, is that oral medications are no longer working, and treatment now relies solely on “specific and often expensive IV antibiotics.”
Dr Faisal attributed the emergence of this XDR strain to “the rampant and incorrect use of antibiotics“, stressing that this misuse has weakened immune responses and fueled resistance. He also warned that the number of cases may spike further after Eid al-Azha, a time when food handling and sanitation are especially critical.
Another concern raised by Dr Faisal is the reliance on substandard testing. He criticized unqualified practitioners and under-equipped labs that often depend on “Typhi Dot” or stool tests, which are prone to giving false positives, especially in people previously exposed to the bacteria.
According to him, the only reliable method for accurate diagnosis is a blood culture test, which, despite taking about seven days, remains the most dependable tool for determining effective treatment.
The symptoms of typhoid typically include high fever, stomach pain, body aches, gas, and digestive issues like constipation or diarrhoea. However, the XDR version is far more aggressive and may severely impact the liver, brain, stomach, and bone marrow if left untreated. In many cases, deterioration occurs even before proper diagnosis, complicating the recovery process.
For those infected, Dr Faisal recommends consuming soft, easy-to-digest foods such as Khichdi (a blend of rice and lentils), yoghurt, boiled vegetables, and fruits to support healing.
He also made a strong appeal to authorities: enforce strict hygiene protocols among eateries and street vendors, many of whom continue to use contaminated water for washing utensils, spreading the disease further.
Public awareness campaigns must urgently promote basic practices like handwashing before eating and after using the toilet, as these remain critical in preventing the spread of typhoid.