Health authorities sound diphtheria alert in Chennai

CHENNAI: The directorate of public health has asked doctors in the city to prescribe children coming with sore throat and fever with erythromycin, an antibiotic that is used to treat diphtheria. The recommendation came after the Institute of Child Health (ICH) told authorities that two children in Chennai showed symptoms of the bacterial disease.

Although sore throat is commonly seen in tonsillitis and laryngitis, the health department has insisted that doctors should not rule out diphtheria. “We don’t have the results for these cases yet, but we have decided to be cautious. We have assumed that they have diphtheria because we have seen an outbreak in the neighbouring states and in some districts of Tamil Nadu,” said director of public health Dr K Kolandaisamy.

On Thursday and Friday, the ICH reported that two children -- aged seven and 13 from Pammal and Seven Wells -- showed symptoms of the disease. About 50 urban and village health nurses were sent to schools and balwadis in the area for mass vaccination of children. By the end of the day, more than 4,000 children were vaccinated.

In some primary health centres (PHC), regular vaccination camps conducted on Wednesdays and Fridays were postponed. “All nurses have been deputed for mass vaccination. We will give the regular vaccine a week or two later,” said a duty doctor in one of the city’s urban PHCs.

The government has asked doctors’ association to inform paediatricians, general medicine practitioners, ENT specialists, MBBS doctors to notify the health department if they see symptoms such as swollen glands, fever nasal discharge and malaise besides grey membrane covering the throat. “While they send samples for confirmation, they should have started treatment. At the same time, we will ensure all children in the area are vaccinated,” a senior infectious disease expert said.

Resurgence of diphtheria, doctors said, was largely because of two reasons. Analysis of the state statistics showed some school students skipped booster DPT doses at the age of five. Studies have shown that the effect of diphtheria vaccines and booster fade away by the time children turn seven. “The disease is deadly even with treatment sometimes. Data shows that overall case-fatality rate for diphtheria is 5% to 10%. In children, death rates can go up to 20%. Children die suddenly during treatment and we can’t predict mortality,” said Dr Balasubramanian S, medical director of Kanchi Kamakoti Childs Trust Hospital.

However, experiences from Eastern Europe and South America have shown that introducing these vaccines in children and pregnant women reduces incidence. At least 133 countries use the combination vaccine as a part of their immunisation schedule. India’s launched it in 2018. “While all children will receive it in class 5 and 10, we are conducting mass vaccinations for all children in affected areas,” Dr Kolandaisamy said.