Doctor Huynh Minh Tuan, Head of the Department of Infection Control, Ho Chi Minh City Medical and Pharmacy Hospital, said diphtheria is an infectious disease, acute poisoning caused by diphtheria bacteria. Anyone who comes into contact with the germs can become infected, especially young children, the elderly, and people with low immunity. Vaccines are available to prevent the disease, but it can still happen in low vaccination areas.

Diphtheria is easily spread through the respiratory tract, through direct contact with the secretions from the nasopharynx mucosa of a patient or a healthy person who is carriers when coughing or sneezing. In many cases, the bacteria of an infected person can be contagious and persist on the surface of surrounding objects for days to weeks, eg in milk, drinking water for up to 20 days; In the cadaver, it lives for 2 weeks ... The disease is more contagious in a crowded residential area or where sanitary conditions are not guaranteed.

On average, after inhaling bacteria 2-5 days, the patient will develop illness. Depending on the location of the pathogen, there will be different mild symptoms. The main symptoms of the disease are pharyngitis, a white pseudo-membrane caused by inflamed cells attached to the throat. Some other complications such as otitis media, pneumonia due to diaphragmatic paralysis ... As the disease progresses, symptoms such as difficulty breathing, difficulty swallowing, vision changes, slurred speech may appear.

In addition, diphtheria toxins, when absorbed into the bloodstream, will cause systemic toxicity, paralysis of the cranial nerve, peripheral motor nerve, sensory nerve, causing myocarditis or arrhythmia, lead to death.

According to the doctor, people who have been vaccinated against diphtheria or have had diphtheria in the past are still able to re-infect because the body does not develop immunity or the immunity decreases over time.

Some cases of diphtheria can die due to inadequate immunization, especially children in remote areas. The rare cases may be caused by a defect in the immune system, which means that it is not immune to immunity despite adequate vaccination.

To evaluate the effectiveness of the diphtheria vaccine injection, you can perform a Schick response. If the Schick (+) response, it means that the body has no antibodies to diphtheria and need to be vaccinated; if the Schick reaction (-), it means that the body has antibodies that neutralize the toxin and no need to inject.

In Vietnam, when vaccination is not implemented, diphtheria often occurs and causes epidemics in most provinces, especially in cities with high population density. The disease appears more in August, September, and October of the year. After vaccination, the rate of diphtheria fell below 0.01 / 100,000 people.

According to the Department of Preventive Medicine, in the past few years, diphtheria has appeared in many provinces in the Central, Central Highlands such as Quang Nam, Quang Ngai, Dak Lak, Dak Nong, ... Due to remote areas, low immunization rates or people not fully cooperating in vaccination.

Specifically, in August 2019, a 7-year-old boy in Dak Lak was recorded as the first person to die of diphtheria in a year. In June 2020, Dak Nong province recorded 12 cases of infection, of which a 9-year-old girl died, complications of diphtheria were identified. The commune government also set up two blocking teams, isolating all families in the outbreak area.

"Diphtheria is a disease with specific drugs, so it can be treated effectively. The carrier that does not detect it in time will become a source of danger to the community", the doctor emphasized.

To proactively prevent diphtheria, families should take their children for vaccination. The diphtheria vaccine is often combined with the pertussis and tetanus vaccines in the expanded vaccination program.

For young children: the first 3 shots are given a month apart, repeat injections after one year, the next shot every 7-10 years. For adults: 2 shots are given a month apart, repeat nose every 9-12 months, next nose about 10 years apart.

Note, do not vaccinate when the fever but have to wait for the body temperature to drop to normal. Adults with underlying disease need to wait for remission before injecting, under the supervision of a doctor. Pregnant women should get a diphtheria shot in the last 3 months of pregnancy (from 27 weeks to 35 weeks), helping to protect the baby at birth.

Wash your hands often with soap; cover mouth when coughing or sneezing, keep body, nose, and throat clean daily; limit contact with people who are infected or suspected of having an illness. Ensure that houses, kindergartens and classrooms are well ventilated, clean and well-lit.

When there are manifestations of suspected diphtheria, such as fever, sore throat, gray-white pseudomembranous appearance in the throat, the patient needs to seek medical examination, early detection and timely treatment. Particularly, people in the epidemic need to strictly abide by taking preventive drugs and vaccines to prevent diseases, and limit crowds at the request of health authorities.

Thuy An

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