KARACHI, Nov 2: Typhoid — an acute, systemic illness caused by infection with “Salmonella typhi” — which appears to have eradicated from a large part of the world continues to haunt Karachiites.

Pathetic handling of water accumulation on roadside along with frequent instances of water contamination due to leakage in pipelines can be cited as the major factor behind the condition.

Consequently the disease also continues to be an important cause of morbidity in local children, particularly under five years of age.

Typhoid fever is observed to be predominantly a paediatric disorder with almost 70 per cent of all culture proven cases occurring in children. It is, however, equally hazardous for adults as delayed diagnosis and inadequate treatment may lead to complications within any organ.

Salmonella infection of bone and joint that generally account for less than one per cent of all salmonella infections were identified among Karachiites.

Dr Said Minhas of Orthopaedic Department, JPMC, said that osteomyelitis, a rare complication of salmonella infection since the advent of antibiotics, was diagnosed among individuals in age group between 10 and 40 years.

It is also observed with concern among local health professionals that as typhoid has emerged to be a diseases more commonly prevalent in third world, hence, a large majority of pharmaceutical companies appear to be reluctant to invest in the development of anti-typhoid vaccines due to diminished returns.

The data from Pakistan depicts multi-drug resistant (MDR) typhoid fever as a serious systemic illness in young children, which is occurring at higher incidence throughout South Asia.

Studies conducted in Karachi reveal that transmission of typhoid fever was the highest in areas of poor sanitation - mainly urban slums where sewage water mixes with piped water.

Contaminated water and food being sold under extremely unhygienic conditions are generally identified as common contributory factors causing salmonella typhi infections.

Salmonella typhi infections, caused due to salmonella organisms, were also found to be the most common organism isolated from blood samples collected during recent years in Karachi.

Case control studies conducted over the years, during seasons other than monsoons, however, also identified eating ice cream, prior use of antimicrobial, eating food from cabins and drinking water at work leading to salmonella typhi.

Infection in typhoid fever, if not adequately treated, may lead to ingestion of varied organisms and exposed to severe conditions as perforated abdomen with infections may be registered quite commonly among liver, spleen, bone marrow and gall bladder.

It will be pertinent to mention here that salmonella typhi is the only strain, which is exclusively transmittable among people and mainly spreads through oral-faecal route. Delayed or deficient intervention may lead to severe diarrhoea, emphyilitis, ruptured intestine and so forth. —APP