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Vaccination against diphtheria is a priority in Venezuela | via: El Estimulo

El Estimulo | Venezuela | June 17, 2023

Unofficial translation made by HumVenezuela…

Infectious disease specialists warn that they are on alert for a new outbreak, due to the decrease in vaccination coverage, which in Venezuela only reaches 54% of the population.

Diphtheria is a very aggressive disease, but easily preventable with a vaccine. In fact, in Venezuela this condition was controlled during the last 21 years, until 2017 when an outbreak was evidenced.

Now, specialists in Infectious Diseases have indicated that they are on alert, waiting for a new outbreak, due to the decrease in vaccination coverage against Corynebacterium diphtheriae, the bacterium that causes diphtheria.

“If all people were vaccinated with diphtheria toxoid, which is found in the pentavalent and hexavalent vaccines (the first two in children under 7 years of age), and in the tetanus/diphtheria toxoid vaccine (from 7 years of age), we would not have this resurgence,” says Tatiana Drummond, an infectologist at the Piedra Azul Clinic.

She points out that, according to estimates by the World Health Organization (WHO), by the year 2021 in Venezuela, diphtheria coverage reached 54% of the population, while on a global scale it barely exceeds 81%, mainly due to the fact that the COVID pandemic minimized attendance at vaccination centers. “Globally, we have a time bomb in terms of a diphtheria epidemic”, warns the specialist.

Diphtheria in Venezuela

The specialist comments that, so far, officially, three cases have been diagnosed in the state of Bolivar for the month of March of this year, specifically in the mining area of the Municipality of Sifontes, which leads to suppose that there could be other undiagnosed cases; which makes it even more important that people resume vaccination.

Diphtheria is transmitted through saliva droplets from a carrier, who does not necessarily show symptoms. When inhaled by healthy people, they can inflame the pharynx and tonsils to such an extent that they cause tissue necrosis and the person may eventually die from respiratory distress.

The infectologist of the Clínica Piedra Azul explains that this bacterium, which causes diphtheria, produces toxins capable of traveling through the blood to the heart, causing cardiac affectations.

It is a disease of very rapid evolution, which begins with fever and sore throat, swelling of the neck due to inflammation of the tonsils, and the person begins to present respiratory difficulty. “This happens in the first 48 hours. If the disease progresses, cardiac complications can occur after the first week. Once diagnosed, antibiotics such as penicillin (or erythromycin, clarithromycin and azithromycin, for those allergic to penicillin) are given; as well as diphtheria antitoxin.”

The infectologist warns that this is an easily contagious disease if an unvaccinated person is exposed to another infected person, so those who have had contact with patients diagnosed with diphtheria, should undergo a simple test, through a sample collected from the nose and throat, in addition to being monitored for the next seven days after contact.

Drummond comments that the Piedra Azul Clinic has the necessary vaccines, antibiotics, antitoxins and diphtheria tests for the prevention and immediate care of the disease.

Prevention is the most important thing

The specialist affirms that it is very important to make the diagnosis as soon as possible and act accordingly, reiterating prevention and vaccination.

There are several vaccines that prevent diphtheria and can be administered at any age. In the pediatric population, the Pentavalent vaccine is administered. “After seven years of age, it is given in the form of Tetanus Diphtheria Tetanus Toxoid, which is also available at the Health Department and is free of charge, so there is no excuse for not getting vaccinated,” says Dr. Drummond.

Not all people who have diphtheria manifest the disease immediately. These are “healthy carriers”: they don’t have the disease, but are able to transmit it without knowing it.

“I can meet a healthy carrier in crowded places, such as the subway, and if the person coughs, I run the risk of catching it. That is why vaccination is very important, as well as the use of a mask, which protects not only against covid and other viruses, but also against tuberculosis, against bacteria that cause meningitis, and other pathologies that enter our organism through the respiratory tract”.

The infectologist of the Clínica Piedra Azul concludes that it is very important to check the vaccination schedule to make sure it is up to date. “If you have been vaccinated against diphtheria for more than five years, then contact your doctor to schedule the vaccinations you need”.