A strain of typhoid that is currently spreading through Pakistan is resistant to five different antibiotics, more than any previous outbreak. So far there have been 850 cases across 14 districts since 2016. The strain is expected to disseminate globally and replace weaker strains. Only azithromycin has been identified as a successful treatment.

Pakistan is no stranger to Typhoid outbreaks, which occur frequently due to poor infrastructure, low vaccination rates and overpopulated cities. However, the fact that this strain cannot be treated by other antibiotics such as ceftriaxone makes it much harder to contain.

This outbreak represents the real and immediate threat posed by antimicrobial resistance (AMR).  Resistance to antibiotics is increasing by 30 precent each year in the Sindh province, where the outbreak first occurred according to the WHO. Increasing rates of resistance around the globe are causing health officials to take notice. Drugs we have relied on for decades are suddenly ineffective with a limited pipeline of new candidates.

“Everything suggests this strain will survive well and spread easily — and acquiring resistance to azithromycin is only a matter of time” said Dr. Eric Mintz, an epidemiologist at the CDC.

photo credit: The Guardian