Persistence of Diphtheria in India

Sir, We read with great interest the article of Nath and Mahanta(1) about an outbreak of diphtheria in Dibrugarh, Assam. In the last 10 years, there have been a number of reports of either re-emergence or persistence of diphtheria from several Indian states, including Andhra Pradesh,(2) Delhi,(3-6) Maharashtra,(7,8) Chandigarh,(9) Gujarat,(10) Assam,(11) West Bengal,(12) Madhya Pradesh,(3) Uttar Pradesh,(6) Rajasthan(6) and Haryana. (6) The data on vaccine-preventable diseases provided by the Government of India to the World Health Organization (WHO)(13) during 1980–2008 indicate persistence of diphtheria without much decline over the last 25 years [Figure 1]. India accounted for 19–84% of the global burden from 1998 to 2008.

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