Diphtheria concerns in India, Pakistan

While in the United States there were less than five cases of diphtheria reported to the CDC in the past decade, the disease continues to play a role globally. In 2011, 4,887 cases of diphtheria were reported to the World Health Organization (WHO), but there are likely many more cases.

Two countries are reporting serious situations with diphtheria in recent reports-India and Pakistan.

According to the Times of India, Fear has gripped villagers of Gothri in Laxmangarh area of Alwar district where nine children tested positive for diphtheria and six children died of whom four had diphtheria symptoms prompting many villagers to move from the area.

To prevent the spread of the disease, the officials in the area had conducted surveillance and vaccinated more than 200 children in the past 20 days. The first case was reported on October 18 and since then the health department officials are yet to control the situation properly. However, they claimed that no more deaths have happened in the area.

In neighboring Pakistan, The News reports, where polio is a major problem, one pediatrician says “diphtheria looms large as a bigger threat to our children”. “During the last fortnight four cases of strongly suspected cases of diphtheria have been brought to my attention; two from Civil Hospital Karachi and two from a private hospital. All four children were not immunized and unfortunately succumbed to death.

It’s an alarming situation and requires drastic measures to control before it is too late.

Dow University of Health Sciences Pediatrics Chairperson Dr Aisha Mehnaz said that health authorities need to give utmost priority to improve drastically falling immunization rate in the children and at the same time take measures to make anti -diphtheria serum available at all major health centers.

Diphtheria is caused by a potent toxin produced by certain strains of the bacterium,Corynebacterium diphtheriae.

Diphtheria is extremely contagious through coughing or sneezing. Risk factors include crowding, poor hygiene, and lack of immunization.

Symptoms usually appear within a week of infection. This infection is characterized by a sore throat, coughing and fever very similar to many common diseases like strep throat. Additional symptoms may be bloody, watery discharge from the nose and rapid breathing. However, a presumptive diagnosis can be made by observing a characteristic thick grayish patch (membrane) found in the throat. In more severe cases, neck swelling and airway obstruction may be observed.

In the tropics, cutaneous and wound diphtheria is much more common and can be a source of transmission.

Related: India’s dengue fever burden much higher than what’s reported: study

The real serious danger is when the toxin that is produced by the bacterium gets into the bloodstream and spreads to organs like the heart and nervous system. Myocarditis, congestive heart failure and neurological illnesses of paralysis that mimic Guillain-Barre syndrome are most severe. Even withtreatment, fatalities are still seen in up to 10% of cases.

Diphtheria can be treated and cured successfully with antitoxin and antibiotics if started early enough.

The prevention of diphtheria is through vaccination. Immunity does wane after a period of time and revaccination should be done at least every 10 years.

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