Diphtheria and measles strike capital

Several cases of diphtheria and measles among children have been reported in the Pakistani capital Islamabad and the adjacent city of Rawalpindi over the past few weeks, raising concerns about the effectiveness of routine child immunisation on the ground. "An emergency operation against the two diseases was launched immediately in particular areas of the two cities where the reports came from, following the diagnosis of diphtheria and measles cases in the first week of April," Dr Jalil Kamran, head of the Epidemic Investigation Cell (EIC) at the National Institute of Health (NIH), told IRIN in Islamabad on Wednesday. His comments came after two cases of diphtheria and six of measles were reported among children under 10, in parts of the two cities over the past five weeks, while previous cases of measles in the capital were registered in 1998, following an outbreak in the capital, the EIC said. As an immediate measure, about 700 children in the capital and Rawalpindi, aged 12 and under, have been vaccinated against diphtheria, while some 400 others have been immunised against measles in the surrounding localities of Islamabad and Rawalpindi, from where the cases were reported. Blood samples from affected children have been sent to NIH laboratories, Kamran said. Diphtheria spreads through respiratory droplets from the throat during coughing and sneezing. This highly contagious disease can lead to an obstruction of the respiratory tract and cause instant death. According to the country's national Health Information Management System (HIMS), out of 100,000 patients who turn up to at public hospitals annually, an average of 16 have measles. "The occurrence of diphtheria is relatively low with one case per 100,000 patients visiting state-run hospitals annually," Dr Syed Muhammad Mursaleen of the HIMS said. "Such a high re-occurrence is alarming since the children are vaccinated against six killer childhood diseases during the [first] nine months after birth," Dr Najeeb Khan Durrani, a World Health Organization (WHO) officer, told IRIN. "Vaccine failure, degradation of the vaccine's quality through poor maintenance of the cold chain, absence of any booster follow-up drops, whatever the reasons might be, there must be a thorough investigation as to why the current interventions are proving ineffective," Durrani maintained. Meanwhile, health professionals are expressing concern over the situation with regard to the two diseases in other parts of the country - particularly in remote rural areas given that they lack an effective surveillance and treatment system compared to the capital.