PESHAWAR: With the Pakistan Paediatric Association voicing concern about the “growing” incidence of diphtheria in Khyber Pakhtunkhwa, the health department has intensified campaigns to ensure the children’s vaccination for protection from the acute contagious infection.

PPA president Dr Mohammad Hussain told Dawn that diphtheria in the province had reached epidemic proportions.

“This [diphtheria] is a vaccine-preventable infectious disease, which causes deaths in children and elderly people due to upper airway obstruction, myocarditis [heart blocks] and neuropathies [damage to the peripheral nerves],” he said.

The PPA leader said diphtheria was endemic in Asia and its cases were reported in southern districts of Khyber Pakhtunkhwa in 2016 prompting the association to recommend mass immunisation in the affected districts of Bannu, Karak, Kohat and Lakki Marwat.

“A mass immunisation drive was carried out covering children up to 15 years but due to poor follow-up, the diphtheria resurgence was reported in Bannu, Karak, Kohat and Lakki Marwat killing children. It also spread to the entire province,” he said.

Dr Hussain complained that the province neither had any children’s hospital nor was there any single room isolation and proper triage system for diphtheria patients.

“We request authorities to take immediate steps to control this deadly infection from spreading,” he said.

The PPA leader called for mass immunisation, diphtheria surveillance and public awareness and said some patients required pacemakers, whose immediate supply by the government to hospitals could save lives.

“Diphtheria with the worst complications like myocarditis is highly prevalent in our province,” he said.

Dr Hussain, a senior pediatrician at Peshawar’s public sector Lady Reading Hospital, told Dawn that the government was either unaware of the diphtheria epidemic or didn’t take it seriously. He said the situation was becoming “extremely dangerous” for children in the province.

“Patients need anti-diphtheritic serum, which is provided by the World Health Organisation only. It often runs short due to high demand. If patients develop myocarditis [heart blocks], then most of them die,” he said.

Dr Hussain said non-vaccination or poor implementation of the immunisation programme seemed to be the main reason for the persistence of diphtheria in most districts.

He said a few years ago, it was found out that none of the 56 diphtheria cases included in a study had got the three basic doses and boaster vaccine.

“Prevalence of diphtheria in our province needs attention. This disease can be easily eradicated through mandatory routine immunisation and booster doses in children, early management of contacts of the cases with antibiotics and vaccination, and provision of anti-diphtheria serum at health facilities and its timely administration to patients,” he said.

When contacted, EPI director Dr Mohammad Arif Khan said efforts were under way to access unvaccinated children after the detection of more than 260 diphtheria cases in the last few months.

“We are scaling up public awareness to do away vaccine hesitancy at community level. For us, the matter of actual concern is that the people aged above 60 and 70 years are getting infected,” he said.

Dr Arif said that vaccines were available at EPI centres free of charge, while health workers were visiting from house to house to ensure the vaccination of children under two years of age.

He said diphtheria was highly infectious, so vaccination was highly recommended.

“Unvaccinated children are at risk of getting the infection. In case of this happens, the patients requireanti-diphtheria serum, which is very costly and not readily available,” he said.

Published in Dawn, November 19th, 2023