Resurgent diphtheria killing children across Pakistan: officials

ISLAMABAD: Despite claims of an increase in routine immunization rates in the country, at least 39 children and teenagers have so far died across Pakistan due to deadly infectious diphtheria, a vaccine-preventable disease which was wiped off from most parts of the world, showing failure of Pakistan’s routine immunization programme, The News learnt.

“So far 39 children have lost their lives due to the deadly infectious disease diphtheria in entire Pakistan. Diphtheria is a lethal bacterial infection, a vaccine-preventable disease, but every week dozens of diphtheria cases are now being reported from Punjab, Sindh, Khyber Pakhtunkhwa and Balochistan while suspected diphtheria cases are also being reported from Azad Jammu and Kashmir”, an official of the National Health Services, Regulations and Coordination (NHS,R&C) told The News Thursday.

Infectious disease experts and paediatricians are blaming the federal and provincial programmes of immunization for the rise in cases and calling for an immediate overhaul of the federal and provincial Expanded Programme on Immunization (EPI).

According to experts, diphtheria is a serious infection caused by strains of bacteria called ‘Corynebacterium diphtheria that make toxins. It can lead to breathing, heart rhythm problems, and even death. Pakistani children are given a vaccine, a combination of five vaccines that protects from five major diseases: diphtheria, tetanus, pertussis (whooping cough), hepatitis B and Haemophilus influenza type b (DTP-hepB-Hib).

The NHS official said the highest number of deaths due to diphtheria have been reported from Sindh, where at least 23 children lost their lives due to vaccine-preventable disease, followed by KP where 14 children have lost their lives while two deaths have been reported from Punjab. The health ministry official maintained that so far 342 suspected cases of diphtheria have been reported from Sindh, Punjab, KP and Balochistan, of them 289 were investigated and 22 were confirmed by the lab. “But 144 children were found to be infected with diphtheria based on clinical examination while 1 case was epidemiologically linked, so we have a total 165 diphtheria cases, of which 39 patients lost their lives”, the health ministry official added. Vaccine-Preventable Diseases (VPD) data also suggests that cases of Pertussis and Neonatal Tetanus were also on the rise in Pakistan as 123 cases of Pertussis and 352 cases of Neonatal Tetanus have so far been reported in the country.

Commenting on the resurgence of diphtheria in Pakistan, senior pediatric diseases expert Dr Asad Ali said diphtheria cases were being reported from Karachi and other parts of Sindh and children were dying due to deadly infectious disease, which shows that despite claims of an increase in immunization rates, there are many pockets where children are not being immunized against vaccine-preventable diseases.

“Secondly, there are issues related to the treatment of diphtheria as Anti-Diphtheria Serum (ADS) or Diphtheria Antitoxin is no longer available in Pakistan or it is very hard to acquire as it is no more produced at mass levels due to the elimination of diphtheria from most parts of the world”, Dr Ali added.

Another renowned paediatrician and President of the Pakistan Pediatric Association (PPA) Prof. Jamal Raza said the resurgence of diphtheria in Pakistan was mainly due to authorities’ failure to immunize a maximum number of children. “The reason is very simple; Inadequate Immunization. There is a dire need to boost routine immunization. Officially, it is said that the vaccination rate is around 70 per cent but it is much less than the official figures”, Dr Jamal Raza, the Executive Director of the Sindh Institute of Child Health, told The News.