Diphtheria outbreak in rural North Karnataka, India

Parande, Mahantesh V.; Parande, Aisha M; Lakkannavar, S. L.; Kholkute, S. D.; Roy, Subarna

doi:10.1099/jmmcr.0.003558

Cited by 16 publications

(10 citation statements)

References 2 publications

(2 reference statements)

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“…A diphtheria epidemic in the former Soviet Union in the 1990s resulted in N 157.000 cases claiming~5000 lives (Dittmann et al, 2000). Yet, this pathogen is not under control, and the have been multiple outbreaks in different countries since 2000 including Colombia (Landazabal et al, 2001), India (Parande et al, 2014;Saikia et al, 2010), Norway (Rasmussen et al, 2011), Nigeria (Besa et al, 2014), Thailand (Wanlapakorn et al, 2014), and more recently in Brazil (Santos et al, 2015), Laos (Nanthavong et al, 2015) and Indonesia (Hughes et al, 2015).…”

Section: Diphtheriae Is Genetically Diversementioning

confidence: 93%

Evolution, epidemiology and diversity of Corynebacterium diphtheriae : New perspectives on an old foe

Sangal

Hoskisson

2016

Infection, Genetics and Evolution

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Section: Diphtheriae Is Genetically Diversementioning

confidence: 93%

Evolution, epidemiology and diversity of Corynebacterium diphtheriae : New perspectives on an old foe

Sangal

Hoskisson

2016

Infection, Genetics and Evolution

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“…9 Many outbreaks of diphtheria have been reported in various states of India in recent times. [10][11][12][13][14] A diphtheria outbreak of 593 cases in Indonesia was documented by several provincial health offices between 1 January and 1 November 2017, many occurring in East Kalimantan in children aged 1-10 years. 15 Since there has been a lack of studies on childhood diphtheria in Wahidin Sudirohusodo Hospital, Makassar, we aimed to investigate the clinical spectrum and outcomes of childhood diphtheria in our facility.…”

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confidence: 99%

Clinical spectrum and outcomes of pediatric diphtheria

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Pelupessy

Alimadong

et al. 2019

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Background Although vaccination programs have succeeded in reducing the incidence of diphtheria, it remains a health problem in Asia, including Indonesia. Objective To investigate the clinical spectrum and outcomes of pediatric diphtheria in Wahidin Sudirohusodo Hospital. Methods This study was a retrospective review of childhood diphtheria medical records from January 2011 to December 2017 in Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi. Recorded data consisted of age, gender, nutritional and immunization statuses, signs and symptoms, throat swab culture results, complications, and outcomes. Results Of 28 subjects aged 9 months to 17.10 years, the majority were >5 years (57.1%) and male (60.7%). Subjects’ mean age was 6.15 years and 82.1% of cases were well nourished. Overall, 85.7% had received complete immunizations, while 14.3% were not immunized, having received neither basic nor booster vaccines. The presenting manifestations were fever, pseudomembranes, and sore throat in all subjects, enlarged tonsils (78.57%), dysphagia (67.86%), cough (57.14%), headache (57.14%), hoarseness (67.86%), bull neck (25%), and myocarditis (14.3%). Most subjects had hospital stays of >10 days (67.9%). Mortality was 14.3%, usually in those admitted with a late, deteriorating condition and dying before getting optimal treatment. Poor outcome was significantly associated with the lack of basic or booster immunizations, poor nourishment, bull neck, myocarditis, and hospital stays < 5 days (P<0.05 for all). Conclusion The clinical spectrum and outcomes of pediatric diphtheria in this study are relatively similar to reports from other hospitals. Mortality was mostly in patients who lack basic or booster immunizations, are poorly nourished, or have bull neck, myocarditis, or hospital stays < 5 days.

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“…Airway compromise (25 patients) was the most common complication observed followed by myocarditis (20 patients), cardiogenic shock (19 patients), acute kidney injury (17 patients) and thrombocytopenia (18 patients). 5 Patients received IVIG, with no mortality benefit. Most common ECG abnormality was T wave inversion followed by ST segment depression and heart blocks.…”

Section: Discussionmentioning

confidence: 99%

“…There have been case reports from developed nations also, with some cases in adults, for example -Australia (2011)fatal diphtheria in a young woman, Spain (2015) 6-year-old unvaccinated child, Belgium (2016) fatal case in an unvaccinated child, to name a few. [4][5][6][7] Despite success of mass immunization worldwide, it remains a lethal resurgent infection. However, reports of resurgence/persistence of diphtheria represent the tip of the iceberg as not all cases are not reported or published.…”

mentioning

confidence: 99%

Clinical profile and predictors of outcome of patients with diphtheria in tertiary care pediatric centre from Southern India

Vinayaka

Manoj

Basavaraj

2018

Int J Contemp Pediatr

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Background: Diphtheria is still a fatal infectious disease even in this era of universal immunization. The disease has been completely eradicated in most of the developed countries. On the contrary, in developing countries, although the incidence has drastically declined, still account for 80-90% of global burden. The objectives of this study is to study the clinical profile and predictors of outcome of patients with diphtheria.Methods: All children between the age group of 0 to 15 years admitted with signs and symptoms of diphtheria during January to August 2017 formed the study group. Throat swab for Albert’s stain and culture sensitivity were sent in all patients at the time of admission. All children were started on parenteral crystalline penicillin and Anti Diphtheritic Serum as recommended. All details that is demographic data, clinical features, immunization status, complications and outcome were entered in a proforma and analysed. Several variables were compared among the survivors and non-survivors to determine the predictors of outcome. Outcome is defined as either recovered or died.Results: A total of 42 patients were included in the study group. Among 42 patients, 21 (50 %) were between 5-10 years, 12 (28 %) were between 0-5 years and 9 patients (22 %) were more than 10 years. Most common symptoms were fever followed by throat pain, difficulty in swallowing and bull neck. Alberts stain was positive in 83% of cases and culture positivity in 30% of cases. Myocarditis (47%) was the most common complication followed by acute kidney injury (40%), airway compromise (59%) and thrombocytopenia (42%). A total number of 19 patients died.Conclusions: Diphtheria is highly fatal disease with increased mortality. Myocarditis was the commonest and most serious complication. Presence of myocarditis, AKI, thrombocytopenia, airway compromise and inadequate immunization are important predictors of outcome.

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Diphtheria outbreak in rural North Karnataka, India

Cited by 16 publications

References 2 publications

Evolution, epidemiology and diversity of Corynebacterium diphtheriae : New perspectives on an old foe

Evolution, epidemiology and diversity of Corynebacterium diphtheriae : New perspectives on an old foe

Clinical spectrum and outcomes of pediatric diphtheria

Clinical profile and predictors of outcome of patients with diphtheria in tertiary care pediatric centre from Southern India

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