Rising Cases of Diphtheria

• 22 Mar 2021

Why in News

A recent study has found that Diphtheria, which is a relatively easily-preventable infection, could become a major global threat.

Key Points

• Data:
  
  • Global Rise: The number of diphtheria cases reported globally has been increasing gradually. In 2018, there were 16,651 reported cases, more than double the yearly average for 1996-2017 (8,105 cases).
  • Indian Scenario: According to the World Health Organization (WHO), India reported 2,365 cases in 2015. However, in 2016, 2017 and 2018, the numbers rose successively to 3,380, 5,293 and 8,788.
    
    • As per the WHO, India accounted for 60% of all diphtheria cases globally in 2017.
    • In 2018, Delhi witnessed the death of more than 50 children because of Diphtheria.
• Reasons:
  
  • Antimicrobial Resistance (AMR): Diphtheria has started to become resistant to several classes of antibiotics.
    
    • Antimicrobial resistance is the resistance acquired by any microorganism (bacteria, viruses, fungi, parasite, etc.) against antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics) that are used to treat infections.
  • Covid-19 Impact: Covid-19 has severely impacted vaccination schedules in different parts of the world.
    
    • According to the recently released UN Report on the Impact of Covid-19 on Children, suspension of immunization campaigns will set back the decades-long effort to eliminate various diseases.
  • Misunderstanding of Disease: Parents often misunderstand the disease as usual cough and cold and take medicines from a physician. Since the child has not been given diphtheria shots, with the passage of time, the toxin released from the bacteria starts hampering the functioning of the kidney, heart and nervous system.
  • Vaccine Hesitancy: It refers to delay in acceptance or refusal of vaccines despite availability of vaccine services. It is complex and context specific varying across time, place and vaccine.
    
    • It is influenced by factors such as complacency, convenience and confidence.

Diphtheria

• Caused by Bacteria:
  
  • Diphtheria is primarily caused by the bacterium Corynebacterium diphtheriae.
• Symptoms:
  
  • Common cold, fever, chills, swollen gland in neck, sore throat, bluish skin etc.
• Impact:
  
  • The primary infection is in the throat and upper airways. Produces a toxin affecting other organs.
  • One type of diphtheria affects the throat and sometimes the tonsils.
  • Another type causes ulcers on the skin.
• Spread:
  
  • It is mainly spread by coughs and sneezes, or through close contact with someone infected.
• Target Population:
  
  • Diphtheria particularly affects children aged 1 to 5 years.
    
    • Occurrence of diphtheria cases in under-five children reflects low coverage of primary diphtheria vaccination.
• Fatality Rate:
  
  • Diphtheria is fatal in only 5-10% cases.
    
    • Fatality Rate is the proportion of people who die from a specified disease among all individuals diagnosed with the disease over a certain period of time.
• Treatment:
  
  • Administering diphtheria antitoxin to neutralize the effects of the toxin, as well as antibiotics to kill the bacteria.
  • Diphtheria is preventable with use of antibiotics and vaccines.
• Vaccination:
  
  • The diphtheria vaccine is among the oldest vaccines in India’s Universal Immunisation Programme. As per data from the National Family Health Survey-4, the coverage of diphtheria vaccine is 78.4%.
  • 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 a vaccine against diphtheria, pertussis, tetanus, Hepatitis B and Haemophilus influenzae type B).
    
    • It is also included among the combination of eight vaccine doses which are administered in the first year of life under the full immunisation programme.
  • Recently, the Intensified Mission Indradhanush (IMI) 3.0 scheme has been rolled out to cover children and pregnant women who missed routine immunisation during the Covid-19 pandemic.

Source: DTE