A Study of Outbreak Cases of Diphtheria Diagnosed At Civil Hospital, Ahmedabad
A Study Of Outbreak Cases Of Diphtheria Diagnosed At Civil Hospital, Ahmedabad
Keywords:
Case fatality rate, Corynebacterium diphtheriae, Immunization, Under five proportional mortality rateAbstract
Background & objective: Most of the vaccine- preventable diseases have shown a decline with the advent of National immunization schedule but Diphtheria is still present in some region of India. The purpose of this study is to diagnose outbreak cases of Diphtheria. Method: This study was performed during JUNE 2016 to OCTOBER 2016 at the Bacteriology Laboratory of Microbiology Department, Civil Hospital, Ahmedabad- as IDSP state reference laboratory. Two throat swabs received from each suspected patient with detailed clinical and immunization history. One swab was inoculated in selective and enrichment culture media while another was used for microscopic examination for isolation of Corynebacterium diphtheria. Result: Out of total 126 samples Corynebacterium diphtheriae was isolated in 10 samples. Among 10 cases, 7 were dead, so case fatality rate is 70%. Out of 7 deaths, 4 patients belonged to under 5, while 3 belonged to 6-12 years of age group. Interpretation & Conclusion: The majority of cases are reported from children who were non-immunized or partially immunized against Diphtheria. Persistence or resurgence of Diphtheria is mainly due to low coverage of primary immunization as well as booster doses and inaccessible areas. Targeted immunization coverage is required specifically in inaccessible areas. [Sathwara N NJIRM 2017; 8(2):55-58]
References
2. Gujarat fact sheet, coverage evaluation survey2009, Page1-8.
3. Havaldar, P.V. 1992. Diphtheria in the eighties: Experience in a South Indian District Hospital. J. Indian Med. Associ., 90: 15–56.
4. World Health Organisation. 2010. Immunisation, surveillance, assessment and monitoring. (Last Accessed on 2010 oct 07).
5. National Family Health Survey (MCH and Family planning), India 1992–93. Bombay 11PS; 1995. Int. Institute for Population Sci.
6. National Family Health Survey (NFHS-3), 2005–06. India. Mumbai: 11PS:2007. International Institute for Population Sciences (11PS) and Macro International.
7. Manoj, V., Murhekar, Sailaja Bitragunta. 2011. Persistence of Diphtheria in India, Indian J. Community Med., 36(2): 164–165.
8. Winn WJ, Allen S, Janda W, Koneman E, Procop G, Schreckenberger P, Woods G. Aerobic and Facultative Gram-Positive Bacilli, Koneman’s Color Atlas and Textbook of Diagnostic Microbiology (Sixth Edition), Lippincott Williams & Wilkins, Philadelphia. 2006; pp 765-840.
9. Centers for Disease Control and Prevention (CDC). Use of Diphtheria Antitoxin (DAT) for Suspected Diphtheria Cases, Atlanta. 2012. Available athttp://www.cdc.gov/diphtheria/downloads/protocol.pdf. Accessed 20th September 2015.
10. Ray SK, Das Gupta S, Saha I. A report of diphtheria surveillance from a rural medical college hospital. J Indian Med Assoc. 1998;96:236-38.
11. Havaldar PV. Diphtheria in the eighties: experience in a south Indian district hospital. J Indian Med Assoc. 1992;90:155-56.
12. Dravid MN, Joshi SA. Resurgence of diphtheria in Malegaon and Dhule regions of north Maharashtra. Indian J Med Res. 2008;127:616-17.
