RECENT CASES OF DIPHTHERIA IN A METROPOLITAN CITY

Abstract

Introduction: Diphtheria is an acute, highly infectious and previously endemic disease. Due to the vaccine preventable nature of the disease and initial steady decline, not much attention had been given towards this disease. Recent increase in the number of clinically suspected and laboratory confirmed cases of diphtheria have been observed in our laboratory. Aims and objectives: To study the status of resurgence of the disease in a tertiary care hospital of Mumbai. Materials and methods: 76 throat swabs and 1 slough material from 57 clinically suspected cases of diphtheria over a period of one and a half year from July 2018 to December 2019 were obtained and were processed for microscopy and culture for Corynebacterium species by standard microbiological techniques. Results: Eighteen (23.37%) out of 77 samples yielded Corynebacterium species on culture. Out of 57 suspected patients, 11 were culture confirmed diphtheria (19.29%). None of the patients were less than 5 years of age, 55% were between 5 and 9 years and 45% were above 10 years of age with a total female preponderance of 64%. The immunization status was unclear in 27% cases. All the smear and/or culture positive cases were informed immediately to the clinicians so that the patients could be transferred to the Infectious disease hospital for further management. Conclusion: The study has shown an increase in the number of Diphtheria cases in a metropolitan city, which is a cause of concern in healthcare. There is also a shift in age to older children (> 5 years). The study also highlights the need for confirmation of toxin production to facilitate early information to the treating clinicians.