The diphtheria vaccine is among the oldest vaccines in India’s Universal Immunisation Programme, yet cases in the country have been going up over the last few years after showing a remarkable reduction in 2015. That is why the season’s first death due to diphtheria in Delhi has caused an alarm, with doctors assessing their preparedness.

A look at diphtheria, the vaccination programme and the concerns:

The disease
Diphtheria is an infectious disease caused by Corynebacterium diphtheria, a bacterium. The primary infection is in the throat and upper airways.

According to the National Health Portal, one type of diphtheria affects the throat and sometimes the tonsils. Another type causes ulcers on the skin; these are more common in the tropical regions. Diphtheria particularly affects children aged 1 to 5 years. In temperate climates diphtheria tends to occur during the colder months.

Diphtheria is fatal in only 5-10% cases. That is why as the monsoon approaches and temperatures start to come down Delhi witnessed a diphtheria outbreak.

Periodic outbreaks of the disease have been reported in India. Integrated Disease Surveillance Programme (IDSP), National Centre for Disease Control (NCDC), Delhi, reported as many as 7 outbreaks of diphtheria in India during 2014.

In 1978, India launched the Expanded Programme on Immunisation. The first three vaccines in the programme were BCG (against TB), DPT (diphtheria, pertussis, tetanus) and cholera. In 1985, the programme was converted to the Universal Immunisation Programme (UIP). DPT continues to be a part of UIP, which now includes 12 vaccines. It is now incorporated as a pentavalent vaccine, (containing vaccine against diphtheria, pertussis, tetanus [DPT], Hepatitis B and Haemophilus influenzae type B). UIP aims at giving all children born in India all these 12 vaccines free.