There is a quiet resurgence in the last three years of the once dreaded disease diphtheria in the last three years- an acute respiratory disease- primarily affecting children. Cases in India far outnumber those of any other country in the world according to WHO (World Health Organisation).
Sixty five people died of diphtheria in 2008.
The total number of cases reported in the country steeply rising from 2834 in 2006, to 3354 in 2007, and almost doubling to 6081 (with 2139 cases from Karnataka) in 2008, according to the National Health Profiles released by the Central Bureau of Health Intelligence under the Directorate General of Health Services.
WHO’s latest World Health Statistics 2009 from 193 Member States released yesterday compares the 2007 figures of different countries for diphtheria and even then India ’s reported cases at of 2007 at 3354 are the highest in the world.
Indian figures are more than 17 times higher than Indonesia, which is having the second highest figure in the world with just 183 reported cases.
Most countries have reported either zero incidence or figures in single, double digit. The reported incidence in some countries being Iraq 3, Germany 2, Belarus – 5, Malaysia 2, Mynmar –5, Nepal 44, Pakistan 11, Afghanistan 104, Bangladesh 86,Philippines –39, Russian Federation- 91, Sudan –2, Thailand –3, Canada-5, France –1, Vietnam 32, Ukraine – 81, UK - 3.
An acute respiratory disease caused by bacteria diphtheria leads to a thick coating in the nose, throat or airway. Diphtheria takes its name from Greek word ‘dipthera’ referring to the leathery membrane or coating that grows on the tonsils, throat and in the nose.
Before the development of effective vaccines against the disease, even up till the 1920s, there were estimated 100,000 to 200,000 cases of diphtheria with 13,000 to 15,000 deaths.
Former secretary of Indian Academy of Pediatrics and Senior Pediatrician at Safdarjung Hospital Dr Harish Chellani said, “Diphetheria toxin spreads through the blood stream and can damage the heart and kidneys leading to a person’s death. It can also damage the nerves leading to paralysis”.
“We are noticing a resurgence in diphtheria cases. Usually, it is found in children between 5-7 years, but now we are noticing increased number of cases in higher age groups.”
“Diphtheria is a purely vaccine-preventable disease and effective vaccine is available. But national immunization coverage of triple antigen DPT (Diphtheria, Pertussis, Tetanus) is only 50 to 60 per cent. It should be 100 per cent otherwise there are chances of the disease eradication being less,” he said.
Mortality can be prevented by hundred percent immunization and early diagnosis and treatment, he added. An official of Health Ministry who did not want to be identified as he was not a technical person said, “the increase in number of cases may be due to our improved system of surveillance and reporting system.”
The Health Ministry which till now does not have any dedicated personnel or programme to look at Diphtheria per se. Now that the WHO has specifically having pointed out the growing trend of diphtheria in India, one hopes to see health strategies being directed towards controlling its growth.