In early July, two children from Sathyamangalam in Tamil Nadu’s Erode district succumbed to diphtheria. Around this time, several other cases of diphtheria were being reported from the state. The latest information shows that at least 50 people have been admitted to the Coimbatore Medical College and Hospital with diphtheria.
Health officials in the state have begun stepping up measures to ensure that the spread of the disease is contained and that more people are vaccinated. The Directorate of Public Health (DPH) even issued an alert to doctors in Chennai to treat all children presenting with sore throat with an antibiotic used to treat the disease, regardless of waiting for confirmation of a diagnosis. What is diphtheria and why are so many cases being reported now?
Despite several campaigns to raise awareness about the importance of vaccination and ensuring that children are vaccinated according to the immunisation schedule, officials note that discrepancies in immunisation have played a large role in the current outbreak of diphtheria.
Tamil Nadu’s Deputy Director of Public Health, Dr K Kolandaswamy, had earlier told TNM that the current spike in the number of cases had to do with lack of immunisation. While several parents had skipped vaccinating their children at a young age, many others had not ensured that the booster dose was taken at a later age. However, in light of the recent outbreak in which both young people and adults have been affected, preventive measures have been stepped up. Not only are children being given the vaccine and booster doses (as deemed necessary), but so are adults.
Symptoms and immunisation
Diphtheria is a disease caused by the organism Corynebacterium diphtheriae and is highly contagious. Symptoms of diphtheria are often very similar to that of a common cold or any mild respiratory infection, which makes it difficult to differentiate between diphtheria and a more generic infection.
An infected individual may begin to present with symptoms anywhere from 2 to 10 days after exposure to the bacteria. The infected person usually develops a sore throat which aggravates and will generally develop other respiratory issues as well, if left untreated. While the treatment for diphtheria consists of antibiotics and supportive measures as necessary (painkillers, fluids, etc), it has been determined that the best course of action is to take preventive measures.
In Chennai, two children who presented with sore throat and cold last week were suspected to have contracted diphtheria. Following this, as a preventive measure, the DPH has announced that all such cases will be treated as diphtheria and started on medication for the same. In addition, immunisation efforts have been doubled in parts of Erode and Coimbatore, with several private hospitals in the state also being encouraged by the government to ensure vaccination efforts were in place.
The vaccine against diphtheria is given as a pentavalent vaccine (offers immunisation against 5 diseases: diphtheria, pertussis, tetanus, hepatitis B and Hib-Haemophilus influenzae type b). It is given at 1.5, 2.5 and 3.5 months of age. The DPT vaccine (trivalent, covers 3 diseases: diphtheria, pertussis and tetanus) is given between 16 to 24 months of age. When the child is around 6 years old, another booster dose is required. In addition, the Centre has also advised that children be given the Td vaccine (covers tetanus and diphtheria) at age 10 and age 15.