Diphtheria

WHO team reaches Rajasthan’s Deeg after 7 children die of diphtheria in a month.

Challenges in Diphtheria Vaccination

• Vaccination Efforts: Large-scale vaccination drives initiated, especially targeting children, as diphtheria is a vaccine-preventable disease.
• Resistance to Vaccination: Local population reluctant to vaccinate children due to superstition and misinformation.
• Previous Drives: Multiple vaccination drives have been organized in the past, but opposition from locals has hindered progress.

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About Diphtheria

• Contagious Bacterial Infection: A serious bacterial infection caused by Corynebacterium diphtheriae.
  • The bacteria produces a toxin affecting the upper respiratory tract, heart, and nerves.
• Transmission: Spread through respiratory droplets (coughing or sneezing)
  • It can also spread through contact with infected sores/ulcers.
• Symptoms: Fever, sore throat, swollen neck glands, weakness, and grey coating in the throat, making breathing difficult.
• Complications: Includes heart inflammation, nerve damage, and can be fatal in around 30% of untreated cases, especially in children under 5 years old.
  • Over Fatality rate is around 15% in Children.

Prevention for Diphtheria

• Vaccine Preventable: Diphtheria is prevented by vaccines, usually given in combination with tetanus, pertussis, and other childhood diseases.
• Multiple Doses: Requires 6 doses of vaccine from infancy to adolescence for long-term protection.
• Routine Immunisation: Covered under the Universal Immunization Program in India as Diphtheria, Tetanus, and Pertussis (DTP).

Risk Factors

• Non-immunized/Under-vaccinated Individuals: Most at risk, with outbreaks occurring when vaccination coverage drops.
• Under-vaccination Impact: Recent diphtheria outbreaks have highlighted the need for sustained high levels of vaccine coverage.

Treatment for Diphtheria

• Antitoxin & Antibiotics: Diphtheria antitoxin (DAT)neutralizes unbound toxins, while antibiotics prevent further bacterial growth.
• Supportive Care: Airway obstruction and myocarditis are monitored and treated to reduce complications.
• Contact Precaution: Close contacts of patients should receive antibiotics and vaccination if unvaccinated or under-vaccinated.

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Vaccination Status for Diptheria

• Global Coverage: In 2023, 84% of children worldwide received 3 doses of diphtheria vaccine, but 16% remain under or unvaccinated.
• India Coverage: The coverage rate for DPT3(the third dose of diphtheria, pertussis and tetanus) vaccines, in India rose to an all-time of 93% in 2022.
• Coverage Variations: Significant differences in vaccination levels between and within countries.

Prevention of Diptheria

• High Coverage: Community-wide vaccination embedded in primary healthcare is the most effective prevention.
• Combination Vaccines: Diphtheria vaccines are often combined with vaccines for tetanus, pertussis, and others, increasing protection against multiple diseases.