Few Americans are old enough to remember that diphtheria was once a major cause of illness and death in this country.
“The United States recorded 206,000 cases of diphtheria in 1921 and 15,520 deaths,” the U.S. Centers for Disease Control and Prevention reports.
The widespread use of vaccines transformed that picture. There have been five cases of diphtheria in all of the past 10 years, according to the CDC, or one case every two years on average. No wonder the “D” part of the DTaP vaccine (for diphtheria, tetanus and pertussis) isn’t much discussed. Cases are so rare, it’s not a blip on most parents’ screens.
If only children and parents in other nations were so lucky.
The Pan American Health Organization/World Health Organization (PAHO/WHO) reports that since the beginning of this year, Haiti has had 14 confirmed cases of diphtheria and 48 probable cases. Children younger than 15 are the most affected, and nearly half of those children were not vaccinated. Seven children have died.
According to the CDC, complications from diphtheria can include blocking of the airway, heart damage, nerve damage, paralysis and respiratory failure. Even with treatment, which involves the use of antitoxins and antibiotics, about 1 out of 10 diphtheria patients die. Without treatment, as many as half of patients die.
As a result of the outbreak and the numbers of unvaccinated children, PAHO/WHO is in the midst of a vaccination campaign, along with UNICEF and other organizations, to help the Haitian government vaccinate 2.3 million Haitian children against diphtheria.
“This vaccination campaign seeks to reach all those children who have not received the essential vaccines to be protected against diphtheria,” said Luis Codina, the PAHO/WHO representative in Haiti. “This is also the largest preventive vaccination campaign in the country since 2016, when similar efforts were made towards the elimination of measles and rubella.”
Vaccine protection against diphtheria requires three separate shots over time.
More than 6,300 personnel have been trained and mobilized to administer the vaccines, according to PAHO/WHO. “Local supervision and independent monitoring of vaccination coverage will take place during and after the campaign to ensure the technical quality of the campaign,” PAHO/WHO reports.
According to the CDC, diphtheria is usually spread through respiratory droplets from coughing or sneezing. Occasionally, people can get sick from touching open sores of a sick person, or by coming on contact with a toy or other object that has diphtheria bacteria on it.
The bacteria that attach to the lining of the respiratory system produce a toxin that can cause weakness, sore throat, fever and swollen neck glands. The poison destroys healthy tissues, and within a few days, the dead tissue forms a thick, gray coating that can build up in the throat or nose. This coating is called a “pseudomembrane.” It can cover tissues in the nose, tonsils, voice box, and throat, making it very hard to breathe and swallow.
The poison may also get into the bloodstream where it can damage other organs.
Yet according to statistics from the CDC, only about 85% of American children ages 19 to 35 months are on schedule with their own DTaP immunizations. If parents in this country knew more about the race to save children’s lives in Haiti, they might be likelier to pay more attention to the D in DTaP.
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