Two boys aged 10 and 7 are suspected to have died of diphtheria last week in Banaskantha district, state health department officials said. Five other suspected cases of diphtheria have also been reported from the district, and the patients are undergoing treatment.
“Going by the clinical signs and symptoms, we believe it is diphtheria,” State Immunisation Officer (SIO) Nayan Jani said. “(However) it cannot be definitely confirmed at this point as samples are being tested and laboratory culture reports are awaited. Surveillance activity is ongoing in the district to detect any other suspected cases.”
The laboratory tests can take between three and seven days to confirm diphtheria.
Banaskantha Chief District Health Officer (CDHO) Dr Manish Fancy said, “Of the two suspected cases of death, one boy aged 10 years old was from Deesa, and he was sent to Civil Hospital Ahmedabad last week. He was discharged but then he died at his residence here. The second (patient who died), the seven-year-old boy was from Dhanera. He was treated at Civil hospital, Palanpur and died there. The other five suspected cases are currently undergoing treatment and belong to the age-group of 2 to 20.”
“There are several challenges here. The population is scattered; it is not a cluster of houses in a village but rather each family having a home in the middle of their vast farm,” Dr Fancy says, speaking about the challenges of spreading awareness on immunisation in the district. “When immunisation programmes are conducted, many skip them because they have to walk 2-3 kilometres through kachcha road. The population of women too is largely illiterate and there is very high resistance to immunisation (because of lack of awareness about the benefits of immunisation),” he added. “The 10-year-old who died was brought back to his home despite doctor’s recommendation to continue treatment in the hospital. So right now, we are involving WHO (World Health Organisation) experts (to discuss and come up with a mechanism that may induce more people to attend vaccination camps despite the geographical obstacles).”
The Health Officer said that a team from the state’s health department, including the SIO, had visited the area two days ago to assess the incidence of the disease in the district.
Diphtheria is a bacterial infection where signs and symptoms usually start 2-5 days after exposure and range from mild to severe. Symptoms often appear gradually, beginning with a sore throat and fever. In severe cases, the bacteria produces a toxin that causes a thick grey or white patch at the back of the throat. This can block the airway making it hard to breathe or swallow and also create a barking cough. The neck may swell in part due to enlarged lymph nodes.
According to the WHO website, diphtheria is fatal in 5-10% of cases, with a higher mortality rate in young children.
As per the Universal Immunisation Programme (UIP) in India, all children below one year of age get three doses of Diphtheria-Pertussis-Tetanus (DPT) vaccine at 6, 10 and 14 weeks respectively. This is then followed by two booster doses between the ages of 1-2 years and 5-6 years.