Pretoria - Gaps in the maintenance of the national childhood immunisation schedule have had devastating consequences on the health of children in South Africa, and could very well be to blame for the recent deaths from diphtheria, in KwaZulu-Natal.
Three children died from the highly contagious bacteria in March, almost 25 years after the last case of diphtheria was seen in the country.
“South Africa has an active vaccination programme, but coverage becomes more difficult as children grow older,” said Dr Frew Benson, chief director for communicable diseases in the Department of Health.
Six doses of diphtheria jabs were recommended to keep the bacteria at bay, he said. The first one administered at six weeks, then 10 weeks followed by one at 14 weeks, he said.
“A booster vaccine is given at 18 weeks, a dose given when they start going to school at 6 years and then another when they turn 12.” Missing any of the prescribed dosages lowered a person’s resistance to the bacteria, leaving them highly susceptible to the highly contagious diphtheria bacterium for which South Africa has no treatment.
Diphtheria was a medical emergency, and when the three children had died from similar symptoms, the KZN government declared it an outbreak and started looking for treatment. Fifty doses of the antitoxin were obtained from India, but when the numbers of suspected cases rose to nine by mid-May, government sought assistance from the Japanese government.
“In view of the potential seriousness of the situation, we approached the Japanese government for urgent assistance in obtaining additional supplies of diphtheria antitoxin,” the Health Department’s Dr Terence Carter said.
Japan is one of only three countries worldwide which produced the antitoxin. “Japan is firmly committed to international humanitarian assistance, and from a nationwide campaign in Japan we donate 416 vials of the freeze-dried diphtheria equine antitoxin called Kekatsuken,” Japanese ambassador to South Africa Shigeyuki Hiroki said.
The vials arrived in South Africa on Friday and treatment has already started. “The importance of human life is immeasurable,” the ambassador said at the official handing over of the treatment on Monday.
He said they were happy to be of assistance in an effort to save lives and making a valuable contribution to the welfare of South Africans.
Because it took 10 vials to treat one person, the vials would treat 46 people, Frew said. ”The life span of the antitoxin is not long,” he said.
Once an outbreak was declared, applications to countries which produced it were made for treatment which had to be given within five days of the identification of symptoms.
The Health Department’s acting director-general Tiny Rennie thanked the Japanese ambassador for stepping in as quickly as they did to avert a health crises.
What is Diphteria
*Diphteria is a highly contagious bacterial disease, with often fatal results if left untreated for long.
* It’s a disease of the upper respiratory tract, but can also manifest itself on the skin and rarely on other sites like the eyes, ears and genitals.
* Is caused by the corybebacterium diphtheriae bacterium and is commonly spread through physical contact, or by contact with items used by an infected person.
* Droplets exhaled by an infected person’s sneeze or cough can also contain bacteria.
* Can be spread for up to six weeks by an infected person who might not even show signs and symptoms of diphtheria.
* Is classified as a medical emergency, for which immediate treatment must be administered when symptoms are identified, even if tests have not confirmed diagnosis.
Signs and symptoms can become visible between two and five days after infection. They can include:
* The appearance of a thick, grey membrane covering the throat and tonsils.
* Swollen lymph nodes of the neck.
* Difficulty breathing.
* Chills and fever.
* A loud, barking cough.
* Sore throat.
* Drooling.
* General feeling of discomfort.