A Diphtheria Epidemic in Elazığ, Eastern Anatolia

Abstract

During the one-month period of December 1987, a localized outbreak of diphtheria occurred in Elazlž. Five children who attended the same primary school were affected. None of the children had received complete immunization. Toxinogenic Corynebacterium diphtheria intermedius strains were identified. The first patient with laryngotracheal obstruction was subjected to emergency tracheostomy. He also had cardiac and neurological complications. The other 4 patients were accepted as mild and moderate clinical cases and didn't develop any diphtheritic complications. The cases were isolated in hospital, where diphtheria antitoxin and penicillin were administered.

Keywords

• diphtheritic
• penicillin
• tracheostomy

Doğu Anadoluda Elazığda Bir Difteri Salgını

Abstract

Aralik 1987 tarihinde, bir ayllk süre içinde Elamg'da yerel bir difteri salgml olmustu. Aym ilkokuldan bes çocuk etkilendi. Bu çocuklann hiÇ birisine yeterli dozda karma asl yapllmamlîtl. Mikrobiyolojik incelemeler sonucunda Corynebacterium diphtheria intermedius suslari elde edildi. Tam konulan ilk hastaya larinkotrakeal obstrüksiyon nedeniyle acil trakeostomi uygulandl ve aynl çocuk kardiak ve nörolojik komplikasyonlar geli$tirdi. Dižer dört çocuk hafif ve orta klinik olgular olarak kabul edildiler ve herhangi bir komplikasyon gelistirmediler. Tüm olgular hastanede izole edildiler ve difteri antitoksini, penisilin ve diger destekleyici yöntemlerle tedavileri yaplldl.

Keywords

• difteri
• penisilin
• trakeostomi

References

1. 1. Anderson GSO Penfold JB. : An outbreak of diphteria in a hospital for the mentally subnormal. J Clin Path 26 : 606, 1973.
2. 2. Butherworth A, Abbott JD, Simmons LE et al, : Diphteria in the Manchester area 1967-1971. Lancet Dec : 1558, 1974.
3. 3. Chintu C, Bathirunathan N, Patel JM. : Diphteria at the University Teaching Hospital, Lusaka. East Afr Med J 55 : 36, 1978.
4. 4. Christenson B. : Is diphteria coming back? Ann Clin Res 18 : 69, 1986.
5. 5. Dixon JMS. : Diphteria in North America. J Hyg Camb 93 : 419, 1984.
6. 6. Dutta JR, Ayyagiri A, Qautam AP et al. ; A comparative study of bacteriologically proved and clinically diagnosed cases of diphteria. J Indian Med Ass 67 241, 1976.
7. 7. Feigin RD. : Diphteria. In Behnnan RE, Vaughan VC (ed) : Nelson Textbook of Pediatrics. 13 th ed. Philadelphia, WB Saunders 1987 : p. 593.
8. 8. Grant JPs : Dünya çocuklarmm durumu 1988 (UNICEF). New York, Oxford University Press (Pan Matbaasl) 1988, p. 30.

9. 9. Kanra G, Ceyhan M, Seçmeer G ve ark. Difteri epidemilerinde asllarna ve bakterioloiik incelemelerin önemi (In Turkish). Mikrob Bült. 19 : 152, 1985.
10. 10. Khuri-bulos N. : Diphteria in Jordan : a diminishing yet important Pediatric disease. J Trop Med Hyg 83 : 79, 1980.
11. 11. Kurdi A, Abdulkader M. : Clinical and electrophysiological studies of diphteritic neuritis in Jordan. J Neuro Sci 42 : 243, 1979.
12. 12. Kwantes W. : Diphteria in Europe. J Hyg Camb 93 : 433, 1984.
13. 13. Ledbetter MK, Cannon AB, Costa AF. The electrocardiogram in diphteritic myocarditis. Am Heart J 6B : 599, 1964.
14. 14. Mc Closkey RV, Eller JJ, Green M et al. : The 1970 Epidemic of diphtheria in San Antonia. Ann Intern Med 75 : 495, 1971.
15. 15. Mohanta KD, Parija AC : Neurological complications of diphtheria. Indian Pediat 41 : 237, 1974.
16. 16. Morgan BC. : Cardiac complications of diphtheria. Pediatrics 32 : 549, 1963.
17. 17. Singh M, Saidali A, Bakhtiar A, Arya LSi : Diphtheria in Afghanistana review of 155 cases. J Trop Med Hyg 88 373, 1985.