C T Online Desk: Contagious fever typhoid is taking a serious toll on public health in Bangladesh as the authorities reported 32,276 cases in six months including 5,591 in October alone.
The presence of Covid-19 and dengue appears to be largely overshadowing the prevalence of typhoid.
Public health experts have urged the government as well as the general public to give this disease due attention as the bacterial disease sometimes causes serious complications, damage to vital organs, and even death.
Microbiologist and Child Health Research Foundation executive director Samir K Saha said that during the Covid-19 outbreak in 2020, the cases of typhoid declined significantly, but now they were rising gradually.
The public health researcher said that people must be aware of their intake while the government must ensure safe food for people since the urban-centric disease was entering the human body through food or drink.
CHRF’s surveillance report on Bangladesh Shishu Hospital and Institute stated that the number of typhoid patients more than doubled in the hospital compared with the past year.
In the past 10 months, a total of 400 children have been diagnosed with typhoid. The number was 176 in 2021.
According to the data, in October 46 children were diagnosed with typhoid, compared to 25 in 2021 and 15 in 2020. In September, 60 children were diagnosed with typhoid this year, compared to 23 in 2021 and 15 in 2020.
Typhoid, a highly contagious acute infection, is caused by the gram-negative bacterium, Salmonella enterica serotype Typhi.
Academic and prime minister Sheikh Hasina’s physician, ABM Abdullah, said that bacteria attack people when they allow them to enter their bodies through food or drink.
‘Hand-washing before eating or drinking anything is important,’ he said, emphasising personal hygiene and safe food to prevent the disease.
The Ekushey Padak-winning physician explained that typhoid cases had declined during Covid-19 as people were aware and took homemade, safe food. But now children are taking junk food and drinks from the street without worrying about hygiene, leading to an increase in disease.
Directorate General of Health Services data showed that after May, cases of typhoid were increasing rapidly in the country.
In May, the DGHS reported 3,039 typhoid cases, which increased to 4,367 in June.
In October, DGHS reported 5,592 typhoid cases across the country. The department, however, could provide data on casualties from typhoid.
According to the World Health Organization, 11–20 million typhoid cases are reported globally each year, with a mortality rate of 128,000–161,000 deaths per annum.
Bangladesh, among many other countries, is greatly impacted, with incidence rates of 252 per 100,000 people affected yearly.
However, public health campaigners said that the actual number of patients must be much higher as many people are still outside the government surveillance network.
They said that while the government has special preventive and curative measures for many diseases like Covid-19 and dengue, the same measures were absent for typhoid.
Dhaka Community Hospital Trust chairman professor Quazi Quamruzzaman said that typhoid is a preventable as well as a curable disease.
He said that typhoid and cholera were neglected in Bangladesh for years.
He blamed the unaccountability and anarchy in the country’s healthcare system for sustaining the preventable disease for such a long time in the country.
To prevent the disease, he emphasised both individual hygiene and sanitation as well as government intervention in ensuring safe food for all.
‘Water supplying agencies must ensure safe water, whereas food safety must also be ensured by agencies concerned,’ he said.
He urged people to seek proper treatment from a registered physician as soon as typhoid was suspected.
Public health and preventive medicine researcher and teacher Ariful Haque said that the WHO recommended the vaccine in 2018, but Bangladesh was yet to start immunisation.
He recommended a mandatory, free vaccine for all to prevent typhoid and stressed public awareness about food and beverage intake.
‘The fever can damage any organ of the body,’ he warned, urging the development of sanitation systems.
The programme manager of the Expanded Program on Immunization of the government, SM Abdullah-Al-Murad, said that they applied to the Global Alliance for Vaccines and Immunization for free typhoid vaccine in September.
‘We have plans to inoculate all children aged between nine months and 15 years if we get the vaccine from GAVI,’ he said.
He said that the GAVI committee has a meeting scheduled in the final week of November where a decision would be made about whether Bangladesh would be given the vaccine and in what quantity.
Bangladesh Shishu Hospital and Institute Prof Md Jahangir Alam said that typhoid could transmit to people of all ages and sexes, but it was more common among children.
‘It is not dangerous but neglected. It may turn harmful in the third week of infection if a patient is not given proper treatment,’ he said, adding that typhoid might damage even brain cells.
The physicians said they face problems in selecting antibiotics as many have become resistant to a large number of people in the country due to past misuse.
