Diphtheria: A concern

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By Moderator June 28, 2019 14:08

The season’s first death due to diphtheria has been reported in Delhi. This article is about diphtheria

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  • Diphtheria is fatal in only 5-10% of cases.
  • Cases have been going up in the last few years. In 2015, as per World Health Organization data, India reported 2,365 cases.
    • This was a steep drop from the 6,094 cases reported the previous year. However, in 2016, 2017 and 2018, the numbers rose successively to 3,380, 5,293 and 8,788.
  • As per data from the Central Bureau of Health Intelligence, during 2005-2014, India reported 41,672 cases of diphtheria (average 4,167 per year) with 897 deaths (case fatality ratio 2.2%).
    • Ten of the states (Andhra Pradesh, Assam, Delhi, Gujarat, Haryana, Karnataka, Nagaland, Maharashtra, Rajasthan, and West Bengal) accounted for 84% of the cases reported across the country.
    • In states of Delhi and Uttar Pradesh, most of the cases were among under-five children.
      • The occurrence of diphtheria cases in under-five children reflects low coverage of primary diphtheria vaccination.

Diphtheria

  • Diphtheria is an infectious disease caused by Corynebacterium diphtheria, a bacterium.
  • According to the National Health Portal, one type of diphtheria affects the throat and sometimes the tonsils.
  • Another type causes ulcers on the skin
    • These are more common in the tropics (places where all 12 months have mean temperatures of at least 18 °C). Diphtheria particularly affects children aged 1 to 5 years.
  • In temperate climates, diphtheria tends to occur during the colder months.

The vaccine

  • The diphtheria vaccine is among the oldest vaccines in India’s Universal Immunisation Programme
    • In 1978, India launched the Expanded Programme on Immunisation. The first three vaccines in the programme were BCG (against TB). DPT (diphtheria, pertussis, tetanus) and cholera.
    • In 1985, the programme was converted to the Universal Immunisation Programme (UIP). DPT continues to be a part of UIP, which now includes 12 vaccines.
  • It is now incorporated as a pentavalent vaccine, (containing vaccine against diphtheria, pertussis, tetanus [DPT], Hepatitis B and Haemophilus influenza type B).
    • UIP aims at giving all children born in India all these 12 vaccines free.
  • As per data from the National Family Health Survey 4, the coverage of the diphtheria vaccine is 78.4%
  • The sudden outbreak led the government to commission a study on vaccine hesitancy and ways to deal with it.
    • The study is being done by the Immunisation Technical Support Unit under the ministry of health and family welfare will conduct the study in association with GAVI — an international organisation supported by the Bill and Melinda Gates Foundation working on ensuring vaccine access.

Vaccine hesitancy

  • Vaccine hesitancy is the reluctance or refusal to vaccinate despite the availability of vaccines. It threatens to reverse progress made in tackling vaccine-preventable diseases.
  • Hesitancy results from public debates around the medical, ethical and legal issues related to vaccines.
  • It is identified by the World Health Organization as one of the top ten global health threats of 2019.

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Source: https://indianexpress.com/article/explained/why-diphtheria-is-a-concern-long-time-vaccine-yet-rising-recent-numbers-5803702/

Moderator
By Moderator June 28, 2019 14:08