On diphtheria

Referring to the article New diphtheria strain alters vaccine policy published in The Jakarta Post on Aug. 18, 2001, I would like to make some clarifications to avoid any misunderstanding among our readers.

Diphtheria is an acute, toxin-mediated disease caused by Corynebacterium diphtheriae. The most common sites of infection are the tonsils and the pharynx, and a higher percentage of carriers are found among children below 15 years of age. The most frequent complications of diphtheria are myocarditis, which can lead to heart failure, and pneumonia, which can lead to respiratory failure.

Diphtheria may not confer immunity. As a preventive measure, diphtheria toxoid is available and DTP is the vaccine of choice for children 6 weeks through 6 years of age. The national immunization program provides a primary series of three properly spaced DPT shots during infancy, with one booster dose of DT for those entering primary school. Both vaccines are produced locally at PT Bio Farma Bandung.

Children 7 years of age or older should receive the adult formulation (adult Td), even if they have not completed a series of DTP or DT. DTP and DT contain three to four times as much diphtheria toxoid as Td. The national program does not provide adult Td vaccine. During the diphtheria outbreak in Cianjur a few months ago, the age of cases and susceptible persons ranged from five to 21 years of age. The program provides DT vaccine for children below 7 years of age, and UNICEF supports the imported Td vaccine for older age groups.

I hope this statement will clarify that there is no new diphtheria strain found as of yet.

BUDHI YAHMONO

Secretariat-General

Ministry of Health

Jakarta