Diphtheria awareness grows: Experts, officials join forces to combat outbreak

IV Report

KARACHI: A recent surge in diphtheria cases has sparked widespread concern across Sindh, particularly in Karachi, where the majority of cases have been reported. According to sources at the Sindh Infectious Diseases Hospital and the National Institute of Child Health, the facilities continue to receive suspected diphtheria cases.

The Pakistan Islamic Medical Association (PIMA) has emphasised the need for governmental action to prevent and treat the outbreak. "The situation demands an effective vaccination campaign, along with the provision of antitoxins through government channels across the country," said PIMA President Prof Dr Atif Hafeez Siddiqui.

Dr Siddiqui attributed the outbreak to the ineffectiveness of the Expanded Programme of Immunisation (EPI) during the COVID-19 pandemic. "Many children missed their vaccinations during this period, making them vulnerable to the disease," he explained.

Healthcare personnel have noted that most confirmed cases involve children under five years old. "These children are defaulters of previous years when EPI coverage was not up to the mark,"

Prof Fatima Mir, from AKUH's Department of Paediatrics & Child Health, warned that diphtheria can lead to severe complications. "It's a bacterial disease causing respiratory distress, high-grade fever, and difficulty swallowing," she said. Dr Mir emphasised that the disease primarily affects children under five and people above 60, particularly those unimmunised and malnourished.

To combat the outbreak, Dr Mir recommended mass booster vaccination drives in affected areas. "All contacts of children who have had diphtheria should be vaccinated and treated as potential carriers," she advised.

According to official reports, Sindh has seen a concerning rise in diphtheria cases this year. By October 5, 184 suspected cases were reported across various districts, resulting in 34 fatalities. In October alone, an additional 33 suspected cases have been reported, with 10 of those cases coming from Karachi.

A third-party assessment revealed that 69% of deserving cases received vaccine coverage against diphtheria. However, Dr Mir pointed out that even vaccinated children are not completely protected in an outbreak. "There is a published paper which reported 194 deaths out of 996 cases in 2022, resulting in a mortality rate of 12%," she said.

The Sindh government has claimed that it is meeting the demand for Diphtheria Antitoxins (DAT) smoothly. However, a source in the provincial EPI setting noted that medical superintendents of tertiary care hospitals must procure DAT from their budgets on a priority basis.

As the outbreak continues, healthcare experts stress the importance of sustained vaccination efforts and robust healthcare infrastructure to prevent and manage outbreaks.