For treatment of children at risk: Hospitals, paediatricians struggling to get anti-diphtheria serum

ISLAMABAD: UNICEF and World Health Organization (WHO) officials in Pakistan Saturday said they were struggling to make Anti-Diphtheria Serum (ADS) available in Pakistan for the treatment of children as authorities confirmed that at least 39 children had so far died in different cities due to long-eliminated, Vaccine Preventable Disease (VPD).

Many hospitals and paediatricians approached the federal and provincial health authorities and private importers of biological products for the availability of Anti-Diphtheria Serum (ADS), which is given to children infected with the strains of bacteria called ‘Corynebacterium diphtheria that make toxins, which can lead to severe complications and death of the patients.

“We are working to bring Anti-Diphtheria Serum (ADS) to Pakistan as soon as possible for the treatment of severe cases of diphtheria”, an official of UNICEF confirmed to The News on Saturday.

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 the pentavalent vaccine, which is 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)

Anti-Diphtheria Serum (ADS) or Diphtheria Antitoxin is a medication made up of antibodies used in the treatment of diphtheria. ADS is a solution of concentrated proteins, chiefly globulins, containing antibodies obtained from the blood of horses that have been immunized against diphtheria toxin, an expert in the National Institute of Health (NIH) Islamabad said.

Officials in the National Health Services, Regulations and Coordination (NHS,R&C) said they were receiving requests for the availability of Anti-Diphtheria Serum (ADS) as well as other medication and they have requested the WHO for the availability of these medicines for the treatment and prevention of precious lives of children in Pakistan.

“WHO officials have assured us that they are trying their best to acquire Anti Diphtheria Serum from Russia as well as India, the only two countries which are probably manufacturing this medication for the treatment of severe diphtheria cases”, the NHS,R&C official said.

The official maintained that NIH Islamabad had no immediate plans to produce Anti-Diphtheria Serum (ADS) as there was ‘not an outbreak of diphtheria’, and added that it requires modern equipment to produce medication like ADS and Anti-Tetanus Serum.

“NIH Islamabad used to manufacture Anti-Diphtheria Serum (ADS) some 20 to 25 years back but after 9/11, it stopped the production of the medication due to certain reasons. At the moment, they are manufacturing Anti Rabies Vaccine and Anti Snake Serum but they have no immediate plans to manufacture Anti-Diphtheria Serum in the country”, the official added.

According to the health official, the federal ministry was planning to issue an advisory and guidelines to the provinces and treating physicians to clinically diagnose the diphtheria case and start the treatment of suspected cases with antibiotics so that toxins could not set in and the lives of the patients could be saved.

“In the absence of Diphtheria Antitoxin, physicians must diagnose the case based on clinical examination and if they are sure that a child is infected with diphtheria, they should immediately start the antibiotics to save the life of the patient”, the official said adding that detailed guidelines and advisory would be issued early next week.

Commenting on the resurgence of Diphtheria in Pakistan, the 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.