The vaccine is a surprise benefit for kids
An American journalist’s perspective on diphtheria: How vaccines and antitoxins can end the outbreaks in Haiti, writes Simar Bajaj
Simar Bajaj is an American journalist who has previously written for The Atlantic, TIME, The Guardian, Washington Post and more. He is the recipient of the Foreign Press Association award for Science Story of the Year and the National Academies award for Excellence in Science Communications.
Ivers has experience with diphtheria in Haiti and he believes the only sure way to end this outbreak is through vaccine. Market dynamics could help explain the global shortage of vaccines. She believes if we can get our communities to be highly vaccinations, then we can prevent outbreaks.
According to Louise Ivers the director of the Harvard Global Health Institute, shortages of both vaccines and antitoxins are limiting the effectiveness of the response to the diphtheria outbreak. Only a few companies make the antitoxin and it takes about four weeks to prepare 1,500 of them. “Nobody wants to make it,” says Ivers, because of how rarely this antitoxin is usually needed – there were fewer than 9,000 cases globally in 2021 – and how impoverished communities facing diphtheria tend to be. That puts it in a category of low commercial profit.
The disease, which was a global problem for a while in the 20th century, can be prevented through vaccination. Cases of diphtheria fell after the vaccine was included on the World Health Organization’s essential vaccine list. “Now, it’s an almost forgotten disease,” says Shyaka.
“This can kill by suffocating the patient,” says Adélard Shyaka, medical coordinator for Doctors Without Borders in Guinea. The toxin can damage the body’s organs, especially the heart, kidneys, and nervous system. Such damage — via suffocation, myocarditis, kidney failure and nerve malfunctioning — means diphtheria is fatal in up to 50% of cases without treatment.
Diphtheria is a highly contagious bacterial infection spread through direct contact with infected sores or ulcers but primarily through breathing in respiratory droplets. The bacteria then releases toxins, causing inflammation that blocks the airways; a thick mucus-like substance (called a “pseudomembrane”) can form at the back of the throat.
The RTS,S Campaign in Africa: Planned Action for a Global Malaria Outbreak Prevention Campaign and the Impact on Children in Eastern Kenya
The RTS,S vaccine campaign began on Monday in Cameroon, with the goal of reaching 6.6 million children across 20 African countries by 2025. The global scale-up of the malaria vaccine is projected to save tens of thousands of lives annually, according to Dr. Kate O’Brien, director of the Department of immunizations, vaccines and biologicals at WHO.
Indeed, in 2022, there were an estimated 249 million cases of this mosquito-borne disease globally and 600,000 deaths. Africa was home to almost 500,000 children under 5 years of age.
As an example, he notes that contracting malaria makes you more likely to get salmonella disease – the most common bloodstream infection in Africa with a case fatality of up to 20-25%. A study out of Eastern Kenya found that over half of bacteremia cases were attributable to Malaria, and that it made people more susceptible to other infections.
In an email to NPR, Hamel said that children with HIV or face chronic malabsorption were at higher risk of severe malaria and thus could potentially lead to death. She says that there have been trials in which the reduction in mortality is more than what one would expect from a decrease in malaria deaths alone.
“The parasite is so plastic, so malleable, so quickly able to evolve all these interventions,” Plowe continues. “If you let up pressure, it will evolve, it will change, it will come back.”
A shortage of both vaccines and antitoxins are limiting the effectiveness of response to diphtheria outbreak in Haiti, according to Louise Ivers, director of Harvard Global Health Institute. “Nobody wants to make it,” she added. There were fewer than 9,000 cases globally in 2021 and how impoverished communities facing diphtheria tend to be, Ivers further said.