Vaccination gaps and resurgence of diphtheria in Nigeria: An outbreak simmering for a catastrophe

Abstract

Diphtheria is a highly contagious and potentially fatal infection caused by Corynebacterium diphtheriae and occasionally by C. ulcerans and C. pseudotuberculosis strains [1]. The bacterium primarily causes an acute respiratory infection, forming a firmly adherent throat pseudomembrane in the throat, pharynx, and tonsils, causing a swollen neck (“bull neck”). The pathogenesis of C. diphtheriae is based on its ability to produce diphtheria toxin that can cause extensive damage to the organs and may lead to death if untreated. The toxigenic effects of C. diphtheriae are mainly due to a lysogenic bacteriophage carrying the diphtheria toxin gene (tox) gene that affects protein synthesis. Therefore, the toxin causes inflammation of the upper respiratory tract mucosal surfaces, nerves and heart lesions, leading to symptoms such as sore throat, fever, breathing difficulties, heart rhythm problems, and rarely membranous pharyngitis. Systemic infections such as myocarditis and neuropathy are also associated with diphtheria toxin, thus increasing morbidity and mortality [2]. Transmission of diphtheria is common through inhalation of airborne droplets, sneezing, coughing, or handling contaminated personal items (https://www.cdc.gov/vaccines/pubs/surv-manual/). Keywords: Diphtheria, Vaccination, Nerves ,Heart ,Organs