Diphtheria: a re-emerging public health challenge
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20195713Keywords:
Diphtheria, Diphtheria antitoxin, Nigeria, VaccinationAbstract
Diphtheria is a highly contagious, potentially life threatening bacterial infection caused by Corynebacterium diphteriae. Diphtheria is transmitted from person to person, usually through respiratory droplets and can lead to severe breathing problems, heart failure, blood disorders and death. Diphtheria was basically eliminated after the introduction of the vaccine in the 1940-1950s. However there is presently global concern that diphtheria is reemerging. We herein report nine cases of diphtheria presenting within a period of six months. All cases presented with sore throat, fever, membrane in the oropharynx and bull neck. Eight of the cases had never been immunized against diphtheria. All cases progressed and developed various complications with 8 of the cases dying. None of the cases had diphtheria antitoxin. This cases present the potential for this highly fatal but preventable disease reemerging and the need to be aware of epidemiological features, clinical signs and symptoms of diphtheria so that cases can be promptly diagnosed and treated, and further public health measures can be taken to contain this serious disease.
References
Delbridge L, Guinea AI, Reeves TS. Total thyroidectomy for benign multinodular goiter. Arch Surg. 1999; Besa NC, Coldiron ME, Bakri A, Raji A, Nsuami MJ, Rousseau C, et al. Diphtheria outbreak with high mortality in northeastern Nigeria. Epidemiol Infect. 2014;142:797-802.
Santos LS, Sant'anna LO, Ramos JN, Ladeira EM, Stavracakis-Peixoto R, Borges LL, et al. Diphtheria outbreak in Maranhao, Brazil: microbiological, clinical and epidemiological aspects. Epidemiol Infect. 2015;143:791-8.
Wagner KS, White JM, Lucenko I, Mercer D, Crowcroft NS, Neal S, et al. Diphtheria in the post epidemic period, Europe, 2000-2009. Emerg Infect Dis. 2012;18:217-25.
Sheena K, Pushpa K, Kalpana G, Jaichand J, Rejitha K, Geetha R. Re-emergence of diphtheria in Malappuram district, North Kerala, India. 2018;20(1):37-9.
McGregor RR. Corynebacterium diphtheriae. In Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles and Practices of Infectious Diseases, 7th ed. Philadelphia: Elsevier; 2009: 2687–2693.
Clark KEN. Review of Epidemiology of Diphtheria 2000-2016. Available at: https://www.who.int/ immunization/sage/meetings/2017/april/1_Final_report_Clarke_april3.pdf. Accessed on 10 July 2019.
World Health Organization: Immunization, Vaccines and biological. Vaccine preventable diseases vaccine monitoring systems 2019 Global Summary References Time Series: diphteria. Available at: https://apps.who.int/immunization_ monitoring/globalsummary/timeseries/tsincidencediphtheria.html. Accessed on 10 July 2019.
Sadoh AE, Oladokun RE. Re-emergence of diphtheria and pertussis: Implications for Nigeria. Vaccine. 2012;30:7221-8.
World Health Organization. The immunological basis for immunization series: module 2: diphtheria– update 2009. Geneva, Switzerland: World Health Organization; 2009.
Archary M, Cohen C, de Gouveia L, du Plessis M, McCarthy K, Mlisana K. Available at: http://www.nicd.ac.za/wp-content/uploads/2017/03/ NICD-guidelines_diphtheria_v3_28-May-2018.pdf. Accessed on 19 December 2019.
Paediatric Association of Nigeria Advisory Committee on Immunization. Paediatric Association of Nigeria recommended routine immunization schedule for Nigerian children. Niger J Paediatric. 2012;39:152-8.