Diphtheria spreading among Rohingya refugees

Diphtheria is quickly spreading among Rohingya refugees in Cox’s Bazar, Bangladesh, according to WHO.

As of Dec. 6, more than 110 suspected cases of the severe respiratory disease, including six fatal cases, had been diagnosed by health care workers among the refugees in the coastal city, a WHO press release said.

“These cases could be just the tip of the iceberg,” Navaratnasamy Paranietharan, WHO representative to Bangladesh, said in the release. “This is an extremely vulnerable population with low vaccination coverage, living in conditions that could be a breeding ground for infectious diseases like cholera, measles, rubella and diphtheria.”

The numerous dangers of infection have led officials to take precautions against several diseases among the Rohingya already, Paranietharan said.

“This is why we have protected more than 700,000 people with the oral cholera vaccine, as well as more than 350,000 children with measles-rubella vaccine in a campaign that ended [Dec. 5],” he added. “Now we have to deal with diphtheria.”

Since August, more than 624,000 Rohingya — a largely Muslim ethnic minority long inhabiting Myanmar — have fled the majority-Buddhist country to neighboring Bangladesh, according to the WHO release. According to the U.N., Myanmar security forces have been conducting a brutal ethnic cleansing campaign against the Rohingya.

Those who have fled to Bangladesh continue to crowd into settlements with poor sanitary conditions, according to WHO, which is working with the Bangladesh Ministry of Health and Family Welfare, UNICEF and other agencies to stem the spread of diphtheria.

“Together, they are supporting patient diagnosis and treatment, ensuring adequate supplies of medicines and preparing a vaccination campaign targeting all children up to 6 years [of age] with pentavalent (DPT-HepB-Hib) and pneumococcal vaccines, which protect against diphtheria and other diseases,” the WHO release stated. “Training is already underway for vaccinators.”

WHO has so far acquired 1,000 vials of diphtheria antitoxins — expected to arrive in Bangladesh by the weekend, the release said.

“Combined with antibiotics, the antitoxins can save the lives of people already infected with diphtheria by neutralizing the toxins produced by the deadly bacteria,” it added.

Paranietharan said health officials are taking the steps necessary to control the outbreak.

“We are working with partners to ensure that clinical guidance is available to health workers, and that there are enough beds and medicines for those who get sick,” he said. “But the only way to control this outbreak is to protect people, particularly children, through vaccination.”

WHO spokesman Tarik Jasarevic said that expanding refugee camps is “crucial,” and that his agency can help plan those expansions. However, he added, the decision to do so would have to be made by Bangladeshi authorities.

Diphtheria has also been spreading in Yemen, the Arabian Peninsula nation steeped in civil war. More than 2,000 suspected cases of the disease and nearly 1 million suspected and confirmed cases of cholera have occurred there as aid workers have sought greater access to the country following the partial lifting of a blockade. – by Joe Green

Disclosures: Jasarevic is a spokesman for WHO. Paranietharan reports no relevant financial disclosures.

Reference:

WHO. Diphtheria is spreading fast in Cox’s Bazar, Bangladesh. 2017. http://www.who.int/mediacentre/news/releases/2017/diphtheria-spreading-bangladesh/en/. Accessed December 7, 2017.