In a follow-up on a report last week, the Press Trust of India reports the death toll of children from diphtheria at a municipal hospital in north-west Delhi has risen to 18.

“A total of 18 children have died at the civic hospital so far, 17 of the patients were from outside Delhi and only one belonged to Delhi,” a senior NDMC official said. “From 6-23 September, there have been 147 admissions, out of which 122 belonged to Uttar Pradesh, 11 from Haryana and 14 from Delhi for diphtheria cases. 18 of them have died till date,” he said.

The hospital in north-west Delhi is governed by the North Delhi Municipal Corporation.

This child with diphtheria presented with a characteristic swollen neck, sometimes referred to as “bull neck”. Image/CDC
This child with diphtheria presented with a characteristic swollen neck, sometimes referred to as “bull neck”. Image/CDC

This has prompted North Delhi Mayor Adesh Gupta to set up a panel to look into the cases.

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.

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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.