Diphtheria Resurgence – A Prospective Study in a Tertiary Care Teaching Hospital
Background: Diphtheria was one of the six killer diseases of childhood and was presumed to have been controlled if not eradicated through immunization programme. Emergence of diphtheria once again has challenged our health policies, immunization and public awareness campaign. Stringent measures need to be taken lest the disease is blown out of proportion and control measures fail. Hence, to highlight the resurgence of diphtheria, its repercussion, mitigation activities under taken by the government we have undertaken to pen down this paper.
Methods: This prospective study was carried on n= 5 patients included in our study on the basis of inclusion and exclusion criteria.
Results: Our approach to the diphtheritic patient should be multifaceted and thorough examination and investigation is required by team approach to counter the impact of the toxins released as it starts with Otorhinolaryngological manifestations and terminates with the cardiovascular and neurological complications.
Conclusions: Three major measures are indicated to counter the resurgence of diphtheria i.e. high immunization coverage of target groups, prompt diagnosis and management of diphtheria cases, and rapid identification of close contacts with their effective management to prevent secondary cases.
2. Manjunath Dandinarasaiah, Bhat Kemmannu Vikram, Naveen Krishnamurthy, A. C. Chetan, Abhineet Jain. Diphtheria Re-emergence: Problems Faced by Developing Countries. Indian Journal of Otolaryngology and Head & Neck Surgery. December 2013, Volume 65, Issue 4, pp 314-318.
3. Narendra Patil, Nilesh Gawade, Abhay Gaidhane, Zahiruddin Quazi Syed. Investigating diphtheria outbreak: A qualitative study in rural area. Int J Med Sci Public Health. 2014; 3(4): 513-516.
4. Manoj V Murhekar, Sailaja Bitragunta.Persistence of diphtheria in India, Indian Journal of Community Medicine, Vol. 36, No. 2, April-June, 2011, pp. 164-165.
5. Bhagat S, Grover S S, Gupta N, Roy R D, Khare S. Persistence of Corynebacterium diphtheriae in Delhi & National Capital Region (NCR). Indian J Med Res 2015;142:459-61.
6. Kole A K, Roy R, Kar S S, Chanda D. Outcomes of respiratory diphtheria in a tertiary referral infectious disease hospital. Indian J Med Sci 2010;64:373-7.
7. Reddy BK, Basavaraja GV, Govindaraju M. (2013) Diphtheric Myocarditis: Resurgence in Urban Bangalore, India. J Gen Pract 1:104.
8. Manikyamba D, Satyavani A, Deepa P. Diphtheritic polyneuropathy in the wake of resurgence of diphtheria. J Pediatr Neurosci. 2015 Oct-Dec;10(4):331-4.
9. Manikyamba D, Satyavani A, Deepa P. Diphtheritic polyneuropathy in the wake of resurgence of diphtheria. Pediatr Neurosci. 2015 Oct-Dec;10(4):331-4.
10. Mateen FJ, Bahl S, Khera A, Sutter RW. Detection of diphtheritic polyneuropathy by acute flaccid paralysis surveillance, India. Emerg Infect Dis. 2013;19(9):1368-73.
11. Galazka AM, Robertson SE, Oblapenko GP. Resurgence of diphtheria. Eur J Epidemiol. 1995 Feb;11(1):95-105.
12. Allam RR, Uthappa CK, Duerst R, Sorley E, Udaragudi PR, Kampa S, et al. A Case-control Study of Diphtheria in the High Incidence City of Hyderabad, India. Pediatr Infect Dis J. 2016 Mar;35(3):253-6.