Malaysian health officials are reporting the first diphtheria case on 2019 in the 2-year-old child from Johor Bahru.

Image/qimono via pixabay
Image/qimono via pixabay

The child presented with fever, cough and swelling tonsils on February 16, 2019. The child was taken to the hospital emergency unit on 18 February 2019 in poor condition and was admitted to the pediatric neurologic treatment unit for respiratory assistance and the treatment of diphtheria antitoxin.

Unfortunately, the child could not be saved and died on February 21, 2019 due to diphtheria with multiorgan failure. Detection tests on throat samples showed the presence of Corynebacterium diphtheriae bacteria and the ministry was waiting for laboratory results for confirmation of diphtheria toxin.

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Health officials report the child was unvaccinated.

In 2018, 18 cases with five (5) deaths were reported in Malaysia where four (4) out of five (5) died without immunization. All diphtheria deaths for 2018 involve children under 10 years old.

Diphtheria is a dangerous respiratory disease 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.

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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.

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 with treatment, 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.