Diphtheria

Diphtheria, caused by a toxin (poison) released by bacteria Corynebacterium diphtheriae, is primarily an upper respiratory tract infection. The Mortality rate, generally 5 to 10%, may be as high as 20% in children <5 yr and adults >40 yr of age. Incidence, which was > 1 mn /year in early 19th Century, declined >95% by 20th Century, due to active immunization. It is part of DTaP, free immunization in India.

Despite being vaccine preventable, it is reemerging in various states including Karnataka with increasing deaths. Poor immunization coverage, lack of awareness, facilities for diagnosis and unavailability of DAT (anti-poison) are the root causes.

Symptoms

It is characterized by its formation of thick grey leathery membrane in the back of the throat making voice hoarse, difficult to breathe and swallow.

Who are at risk?

Children and adults who are unimmunized or partially immunized.

How is it transmitted?

Through (i) respiratory droplets through coughing and sneezing (ii) Toys or objects infected with the bacteria (iii) Contact with open sores (skin lesions) (iv) Infected clothing/bedding, etc.

What is the treatment?

Treatment includes antibiotic therapy that kills the bacteria. But administration of DAT (Diphtheria Anti- Toxin) is required in serious cases to neutralize the toxin (poison) already released by the bacterium in the body.

What are the complications?

Complications include (i) Difficulty in breathing (ii) Heart failure (iii) Paralysis and (iv) Death.

Source : ICMR Policy Brief - August 2017