Malappuram’s experience of adults and young adults being vulnerable to diphtheria infection has prompted doctors and health workers to undertake an intensive vaccination campaign.
Doctors across the State have either been vaccinating themselves with Td (tetanus diphtheria) vaccine or enquiring about the vaccine, especially since one of the doctors at the Medical College Hospital, Kozhikode, had contracted the infection, Health Department officials said.
The department has issued a circular asking all health professionals to take three doses of Td vaccine at specified intervals without delay and an order has been placed for five lakh doses.
25 cases, two deaths
So far, 25 cases of diphtheria, including two deaths, have been reported from Malappuram, six cases from Kozhikode, and one case from Kannur. Though there were reports of a possible case from Thiruvananthapuram, there has been no confirmation.
“This is perhaps the best time to push the concept of adult immunisation, which though popular in the West, has never taken off here, even among medical professionals. The medical fraternity and health workers should definitely protect themselves with vaccination, especially in a situation wherein the herd immunity seems to be coming down,” said Sairu Philip, Department of Community Medicine, Manjeri Medical College.
Diphtheria outbreaks have been reported in rich as well as poor nations whenever routine immunisation cover among children went down. Though a booster dose of Td vaccine is recommended every 10 years to ensure that the vaccine-derived immunity has not waned, it had never been followed as diphtheria outbreaks had been unheard of in Kerala till 2008.
With a changing epidemiological situation, newer immunisation strategies should be thought of, including booster doses of all vaccine-preventable diseases for adults, Dr. Philip says.
The DHS has indicated that the department is contemplating replacing the TT (tetanus toxoid) shot given at 10 and 16 years with Td (tetanus-diphtheria) vaccine so that young adults will have longer immunisation cover against both diseases.
Not just Malappuram
Malappuram is not the only problem district. Seven medium focus districts — Kannur, Kozhikode, Ernakulam, Thrissur, Palakkad, Kottayam and Kollam — have also been identified where there are gaps in immunisation cover because of resistance to vaccination.
Kerala’s contribution to the total population of un-immunised/ partially immunised children in the country is pegged at one per cent, of which an estimated 63 per cent are scattered across these seven medium focus districts.
