Typhoid Fever in Pakistan: Symptoms, XDR Typhoid and Prevention
Typhoid fever is one of the most common infections in Pakistan, particularly in summer and the monsoon months. Since 2016, a strain called XDR (extensively drug-resistant) typhoid has spread from Sindh to other parts of the country. It does not respond to many of the antibiotics that used to work, which is why typhoid should always be treated under a doctor’s care.
What causes typhoid?
Typhoid is caused by the bacterium Salmonella Typhi. It spreads through food or water contaminated with the stool of an infected person. Unclean drinking water, street food, raw salads washed in unsafe water and poor hand hygiene are the usual routes.
Symptoms of typhoid
Symptoms usually begin 1 to 2 weeks after infection and come on gradually:
- A fever that rises step by step over several days and may reach 39 to 40°C
- Headache, weakness and body aches
- Stomach pain and loss of appetite
- Constipation in adults, or diarrhoea, especially in children
- A dry cough
- Sometimes faint rose-coloured spots on the chest or stomach
Without proper treatment, typhoid can cause serious complications in the second or third week, such as bleeding or a hole (perforation) in the intestine.
How typhoid is diagnosed
The most reliable test is a blood culture, ideally taken before any antibiotic is started. It confirms the infection and, importantly, shows which antibiotics will work. Rapid tests such as Typhidot and the Widal test are widely used in Pakistan, but they can give false positive or false negative results, so doctors interpret them carefully.
Treatment and why self-medication is risky
Typhoid is treated with antibiotics, chosen according to the culture report and local resistance patterns. For XDR typhoid, doctors in Pakistan commonly rely on azithromycin for uncomplicated cases, and on hospital treatment with injectable antibiotics such as meropenem for severe illness. Older choices such as ciprofloxacin and ceftriaxone often fail against XDR strains.
Taking random antibiotics from a shop for a few days can hide the symptoms without curing the infection and adds to resistance. A few important points:
- Take the antibiotic exactly as prescribed and complete the full course, even after the fever settles.
- Use paracetamol for fever; avoid frequent use of strong painkillers without advice.
- Drink plenty of clean fluids and eat soft, easily digested food.
- Return to the doctor if the fever is not improving after 4 to 5 days of treatment.
Danger signs
Go to hospital immediately if there is severe stomach pain or swelling, blood in the stool or black stools, repeated vomiting, confusion or extreme drowsiness, or difficulty breathing.
Prevention: vaccine and safe water
Pakistan added the typhoid conjugate vaccine (TCV) to the routine childhood immunisation programme in 2019. It is given free at government vaccination centres to children from 9 months of age, and adults can get it privately. One dose gives strong protection.
- Drink boiled or properly filtered water.
- Wash hands with soap after using the toilet and before eating or cooking.
- Avoid raw salads, cut fruit and drinks with ice from roadside vendors.
- Eat food that is freshly cooked and served hot.
Key takeaways
- Typhoid causes a gradually rising fever, weakness and stomach upset.
- XDR typhoid is common in Pakistan, so antibiotics should be chosen by a doctor, ideally after a blood culture.
- Always complete the prescribed course.
- Vaccination, safe water and hand washing are the best protection.
Browse medicines used for typhoid on Medimart. Prescription medicines are supplied only against a valid prescription.
This guide is for general information and does not replace advice from a doctor.