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  • Title: Diphtheria in Jordan: a diminishing yet important paediatric disease.
    Author: Khuri-Bulos N.
    Journal: J Trop Med Hyg; 1980 Apr; 83(2):79-83. PubMed ID: 7381985.
    Abstract:
    Twenty-seven cases of diphtheria (15 male, 12 female) admitted over a 2-year period, 1977-1978, at the Jordan University Hospital were reviewed. The majority were admitted during autumn and were in the 2-9-year age group. Eleven patients were not vaccinated and six were questionably vaccinated; of these seven died. In 10 patients who were partially or completely vaccinated, only one died. Antitoxin was given to 23 patients at varying intervals after the onset of the disease. No antitoxin was given to the patients who were admitted after the tenth day of the illness. Fourteen complications developed in 13 patients. One patient died with upper airway obstruction, four died with myocarditis, and three patients died with the respiratory complications of polyneuritis. The case fatality rate was 29%. While in Jordan the incidence rate of diphtheria has been decreasing steadily, limited outbreaks are likely to continue to occur unless a higher immunization rate is achieved. 27 patients with diphtheria (15 males and 12 females) were treated at the Jordan University Hospital in 1977-78, the majority of whom were 2-9 years of age. There were 8 deaths, giving a case fatality rate of 29%. 11 patients were not vaccinated and 6 were questionably vaccinated; of these, 7 died. There was only 1 death among the 10 patients who were partially or completely vaccinated. Corynebacterium diphtheriae was cultured from the throats of 21 patients. Antitoxin was administered, at varying intervals, to 23 patients. 13 patients developed a total of 14 complications. The deaths in this group were due to upper airway obstruction (1 patient), myocarditis (4 patients), and respiratory complications of polyneuritis (3 patients). In Jordan, the recorded incidence rate of diphtheria has been declining each year. However, unless the immunization level in the community rises to 70%, limited outbreaks of diphtheria will continue to occur. This study documents the increased severity of diphtheria in nonimmunized compared to immunized or partially immunized individuals; the case fatality rate in this group was 41% among the former children compared to 10% among the latter children. Vaccination against diphtheria is available in Jordan at no cost through government-supported maternal-child health centers, and the Ministry of Health has initiated a major immunization campaign targeted against childhood diseases including diphtheria.
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