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Pakistan: First Country To Launch New Typhoid Vaccine

Pakistan has become the first country in the world to introduce a new typhoid vaccine, officials said Friday, as the country grapples with an ongoing outbreak of a drug-resistant strain of the potentially fatal disease.

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Pakistan has become the first country in the world to introduce a new typhoid vaccine, officials said Friday, as the country grapples with an ongoing outbreak of a drug-resistant strain of the potentially fatal disease.

The vaccine, approved by the World Health Organization (WHO), will be used during a two-week immunisation campaign in southern Sindh province.

Sindh is where most of Pakistan’s 10,000 cases of typhoid have been documented since 2017.

“The two-week campaign beginning from today would target over 10 million children of nine months to 15 years of age,” Azra Pechuho, the health minister in Sindh province, said in Karachi on Friday.

The new vaccines have been provided by Gavi, the Vaccine Alliance, to the Pakistani government free of cost.

After the two-week campaign, it will be introduced into routine immunisations in Sindh, and in other areas of Pakistan in the coming years.

After the two-week campaign, it will be introduced into routine immunisations in Sindh, and in other areas of Pakistan in the coming years.

Pakistan spends a meagre amount of its national resources on public health and a majority of its population remains vulnerable to contagious diseases such as typhoid.

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In 2017, 63 percent of the typhoid cases documented and 70 percent of the fatalities were children, according to a joint press release from the Pakistani government, WHO and Gavi.

Recent History

Pakistan Health Authorities reported an ongoing outbreak of extensively drug resistant (XDR) typhoid fever that began in the Hyderabad district of Sindh province in November 2016.

From 1 November 2016 through 9 December 2018, 5 274 cases of XDR typhoid out of 8 188 typhoid fever cases were reported by the Provincial Disease Surveillance and Response Unit (PDSRU) in Sindh province, Pakistan. Sixty-nine percent of cases were reported in Karachi (the capital city), 27% in Hyderabad district, and 4% in other districts in the province.

In January 2017, the Government of Pakistan initiated a public health response to the increasing number of XDR typhoid fever cases in Sindh province.

Community and school awareness campaigns on safe hygiene and sanitation practices were carried out in Hyderabad, including specific health education on hand hygiene, use of safe drinking water, and environmental sanitation.

A typhoid vaccination campaign was commenced on 5 August 2017 in Hyderabad with Vi-polysaccharide typhoid vaccine (ViPS). Approximately 6000 children aged 6 months to 10 years, were vaccinated.

Water purification and sanitation activities were implemented, including distribution of chlorine tablets to affected communities in Hyderabad.

General practitioners and clinicians in Hyderabad were sensitized on the rational use of antimicrobials for typhoid fever by the Department of Health and partners, with support from the WHO.

A typhoid vaccination campaign was commenced on 5 August 2017 in Hyderabad with Vi-polysaccharide typhoid vaccine (ViPS). Approximately 6000 children aged 6 months to 10 years, were vaccinated.

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Updated surveillance tools and a line listing template for data collection on typhoid cases were shared with all the provincial departments of health on 7 September 2018. The purpose of this was to collect additional information and enhance surveillance, particularly about the occurrence and spread of XDR typhoid to other parts of Pakistan, and beyond.

WHO recommended typhoid vaccination in response to confirmed outbreaks of typhoid fever, and that travelers to typhoid-endemic areas should consider vaccination. Further, where the TCV is licensed, WHO recommended TCV as the preferred typhoid vaccine. Typhoid vaccination should be implemented in combination with other efforts to control the disease.

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