Diphtheria and tetanus re-emerge in Karachi, kill five kids in 15 days

Due to sheer neglect and indifferent attitude of the Sindh health department, vaccine-preventable diseases like diphtheria and tetanus, which had been eliminated from the world, have started re-emerging in Karachi where at least three children have died due to diphtheria while tetanus has claimed two lives, health officials said on Thursday.

Experts say diphtheria is a contagious disease that usually infects the nose and throat, and before the development of treatment and vaccines, diphtheria was widespread and mostly affected children under the age of 15.

They say that due to vaccination against the deadly bacterial disease, it was eliminated even from Pakistan, but now its cases are being reported from different areas of Karachi and claiming lives of children.

Similarly, tetanus is another life-threatening bacterial infectious disease, which was eliminated from most parts of the world, including Pakistan, but due to deteriorating environmental conditions and decreasing routine immunisation, children have started contracting the disease and claimed two lives in Karachi this week.

“We have so far admitted 11 confirmed cases of diphtheria, a life-threatening and highly contagious disease, during the last two weeks, of whom three expired while eight are still undergoing treatment in the isolation ward at our health facility,” said Prof Jamal Raza, an eminent paediatrician and director of the National Institute of Child Health (NICH), Karachi.

Claiming that diphtheria was a completely vaccine-preventable disease that had been eliminated from Pakistan and even a vast majority of doctors were unaware about its symptoms and treatment, Dr Raza said he was astonished to see children coming with a “strange set of symptoms”, and added that when they sent their samples for laboratory analysis, it was confirmed that 11 of them were infected with diphtheria, which is usually a respiratory tract infection.

“By the time, we could do anything for these unfortunate kids who could have been saved through routine immunisation. which is given free of charge in Pakistan, three of them had died while eight are still battling for life and we are trying to save their lives,” he said, adding that he was sure there could have been other children who had contracted the deadly disease but died before being diagnosed and reaching any tertiary-care health facility.

Blaming the declining routine immunisation coverage in Karachi, he said officials of the Expanded Program on Immunisation (EPI) claims that routine immunization overage is 50 percent. However, he alleged that these were the concocted figures, saying routine immunisation was far less in different areas of the city and due to that children were contracting all vaccine-preventable diseases like measles, diphtheria and even tetanus.

Tetanus, which is also a vaccine-preventable disease, claimed the lives of two children this week, Prof Raza said and added that they had received five children with tetanus, of whom two children expired, two were undergoing treatment at the health facility while one was discharged upon recovery.

“Tetanus is a severe illness of the central nervous system caused by tetanus bacteria. It can cause death. It’s not contagious but it is completely preventable by a vaccine as efficacy of tetanus vaccine is 100 percent as compared to other vaccines,” Prof Raza said, adding that it was caused by the poison (toxin) of tetanus bacteria.

“Tetanus bacteria usually enter the body through a wound in the skin. Tetanus bacteria live in soil and animal manure. Tetanus occurs more often in warmer climates or during the warmer months. The most common symptoms of tetanus are stiffness of the jaw (lockjaw), stiffness of the abdominal and back muscles, tightening of the facial muscles, convulsions, fast pulse, fever, sweating, painful muscle spasms near the wound area,” he said and added that if these spasms affect the larynx or the chest, the child may not be able to breathe.

Claiming that EPI officials had held out the assurance about emergency vaccination against diphtheria and tetanus in areas from where children were coming with these diseases, Prof Raza deplored that due to apathy of some people, children in Karachi had started dying due to diseases which were long eliminated from our soil.

“We cannot eradicate polio from our soil until and unless we strengthen the routine immunisation. In addition to polio, our children have started dying due to XDR typhoid, measles, and now diphtheria and typhoid, which is becoming a cause of global concern. We need to take this issue very seriously or we would not be able to control the looming outbreaks of deadly infections, killing our children,” he observed.