Peshawar - Low vaccine coverage during the COVID-19 pandemic has led to a rise in cases of diphtheria, as hospitals in Khyber Pakhtunkhwa are receiving a noticeable number of children infected with this rare and serious infection, which usually affects the mucous membranes of the nose and throat.
The paediatric ward of KP’s largest hospital, Lady Reading Hospital (LRH), is overcrowded with children infected with diphtheria, a vaccine-preventable, fatal infectious disease caused by the toxin-producing bacteria Corynebacterium diphtheriae.
According to data, around 212 patients have arrived at Lady Reading Hospital as of October 2024.
The situation is further aggravated due to a shortage of Diphtheria Antitoxin Serum (DAS), a medication made up of antibodies used in the treatment of complications in diphtheria patients.
Complications in most cases are due to the late arrival of patients to hospitals, says Dr. Amir Muhammad of the Pediatric Department at LRH.
The alarming situation regarding the re-emergence of diphtheria is that around 80 percent of the patients are from the “zero-dose” cohort, meaning they have not received any vaccination, observed Dr. Amir Muhammad.
“In Khyber Pakhtunkhwa, the total number of diphtheria cases is around 383 as of November 16, 2024, out of which around 26 patients have died,” informed Dr. Asghar Khan, Director of the Expanded Programme on Immunization (EPI).
Dr Asghar further explained that more than 85 percent of diphtheria patients are above the age of five, representing the zero-dose cohort of children who missed vaccination in 2019 and 2020 due to the COVID-19 pandemic, which diverted the focus of the Health Department toward the coronavirus vaccination. Previously, most diphtheria cases were reported in southern districts, where vaccination coverage was low due to law and order issues. Now, however, the highest number of cases are being reported in Peshawar, followed by Mardan, Charsadda, Nowshera, and Swabi.
He emphasized that the national immunization programme provides vaccinations free of charge to children from birth up to 15 months of age to prevent 12 dangerous diseases, including diphtheria.
Among these vaccinations, the Pentavalent vaccine is given to children three times at different ages, starting at birth and continuing up to the 15th month. The Pentavalent vaccine protects children from five life-threatening diseases, including diphtheria, tetanus, pertussis (DPT), hepatitis B, and Haemophilus influenza. “Vaccine hesitancy, especially regarding the Pentavalent vaccine, is observed among parents due to its side effects, such as fever and swelling,” observed Dr Arif, Coordinator of EPI in Peshawar.
After the first dose of Pentavalent, parents often express reluctance about the second dose because of concerns over vaccine reactions, he added.
Dr Arif said that vaccinators and Lady Health Workers are tasked with counseling parents about the importance of the Pentavalent vaccine in saving children’s lives and informing them about the mild reactions it may cause.
Meanwhile, Dr Asghar informed that the ‘Big Catch-Up’ programme has been launched in the country with the goal of immunizing children who missed vaccinations at the recommended age. In the first phase of the Big Catch-Up program, launched in October 2024, around 124,000 children with zero doses, or those who have not completed their immunizations, have been covered in eight districts of KP, Dr Asghar added.
The second phase of the program will begin on December 2, 2024, and will cover more children in other districts.
Dr Asghar also informed that, within the next few months, the administration of booster doses for diphtheria will begin in the province to protect children from this deadly disease.