Vaccinate your child against diphtheria
DIPHTHERIA is a highly contagious throat infection that can lead to breathing difficulties.
The disease is spread by bacteria called corynebacterium diphtheria, transmitted through air droplets of an infected person while coughing and sneezing.
The bacteria enter through the skin lining of the nose, mouth and throat, causing a white/greyish membrane to form in the throat.
This may lead to difficulty in swallowing and breathing. Symptoms:
– Fever
– Sore throat
– Headache
– Breathing difficulty – White/grey patches on the throat/tonsils
– Swollen glands
– Tiredness
– Swollen/Bull neck According to the Health Ministry’s public health specialist from the Disease Control Division Dr Rohani Jahis, “Once infected, the diphtheria bacteria multiply in the throat and invade lymph nodes and soft tissue around the neck, causing swelling and inflammation. It also releases toxins that attack multiple organs such as the heart, kidney and brain, leading to organ failure, nerve paralysis and eventually death.”
The outcome for someone with diphtheria often depends on the immunisation status, how quickly treatment started, general health and bacteria load.
– Prevention is better than treatment
In Malaysia, infants can be immunised against diphtheria at two months, three months and five months old as part of their free childhood immunisation.
Subsequently, booster doses are given to children at the age of 18 months and seven years old.
“We advocate diphtheria vaccination for all infants and children due to high death rates caused by diphtheria infection.
“Last year, Malaysia reported five deaths out of the 31 diphtheria cases. This means, 16% of the patients have lost their lives to the disease,” she said.
“52% of the cases consist of individuals who were not vaccinated or had received incomplete diphtheria vaccination. The condition of these cases was bad as some of them needed mechanical respiratory support. All five deaths were among the non-vaccinated or had incomplete vaccination,” she said.
Diphtheria infection can be most serious for children under five years old.
“Children can easily succumb to the disease if they have not been vaccinated or have not received the three prime doses. Vaccinated children may still succumb to mild diphtheria disease,” she explained.
According to Dr Rohani, diphtheria vaccination is also more cost-effective compared to treatments.
“There is a vast difference between the cost of diphtheria vaccination and antitoxin, which is given to an infected person to neutralise the toxin secreted by the bacteria.
“An average antitoxin costs around RM550 per vial while one dose of the vaccine costs only RM35. One child needs four doses of vaccine while an infected person requires two to eight vials of antitoxin, depending on their weight and severity of disease.
“Hence, treatment can cost approximately RM1,100 to RM4,400 per patient, as they would also need antibiotics and hospital admission, among other things" she said.
– Mentality of parents – The determining factor
Although the government has long provided free diphtheria vaccination to Malaysian infants and the number of diphtheria cases has reduced over the years, incidents still occur from time to time.
Last year, media reports cited a “vaccine refusal movement” in Kedah, which spread doubts about the contents of the vaccine and its necessity, leading to several cases of death due to diphtheria.
“From National Health Morbidity Survey 2016 study, we noticed that 10% of parents actually refuse to vaccinate their child,” said Dr Rohani.
“Some parents may think that the vaccine contains ingredients that are forbidden by their religion or vaccination is not necessary as the disease has been eliminated from the community. Others may refuse vaccination because they practise homeopathy and naturopathy.
“There are also parents who say they are too busy to take their child for vaccination while some may have forgotten to follow-up after receiving the first and second doses,” she said.
“The most important fact about diphtheria vaccine is that one dose is insufficient. You need at least three doses so that your antibody level can reach the optimum protective state.
“Furthermore, your antibody level will drops over time and hence, a booster is needed,” she explained.
She noticed that people with this hesitancy or refusal mainly reside in the same locality, so the community immunity among this population will be very low.
This may lead to diphtheria outbreaks as it easily spreads from one child to another within the community, as seen in Kedah and Malacca last year.
“Our government offers free diphtheria vaccination in government health clinics set up across the country. This vaccine is available for children aged below seven years, regardless whether they are born in private or public hospitals,” she said.
She urged parents with children below seven who have not received diphtheria vaccination during infancy or if a child had missed certain doses to visit the facilities for vaccination as soon as possible.
The most important fact about diphtheria vaccine is that one dose is insufficient. You need at least three doses so that your antibody level can reach the optimum protective state.
■ This article is brought to you by the Ministry of Health Malaysia.