Diphtheria, a deadly infection, detected in Singapore after 25 years

Diphtheria, a deadly infection, detected in Singapore after 25 years

This is the first local case of the infection detected in Singapore after 1992.

Diphtheria, a deadly bacterial infection was not seen in Singapore for almost 25 years. In fact, the last local case of the disease was seen in 1992, whereas the last imported case was seen in 1996. However, the disease seems to have made an appearance, claiming the life of a 21-year-old worker from Bangladesh.

According to the report, this person succumbed to the infection on Friday, 4 August 2017. He had not travelled outside Singapore, so this seems to be a local case. This is particularly alarming as diphtheria is highly contagious - the chances of contracting it are high if you come in contact with the patient. 

History of Diphtheria

Diphtheria has been causing epidemics for the past 2000 years. It was first described in the 5 century BCE by Hippocrates. Since then, and till 1920, it was the leading cause of infant mortality. However, the development of a vaccine has saved millions of lives since then. And today, only a few cases are detected and most of them are treated immediately.

Singapore is one of the few nations in Asia to have had a considerable diphtheria-free period. According to the statistics published by the World Health Organisation, since 1981, less than 20 cases have been reported. In contrast, Malaysia reported 31 cases in 2016 alone. 

What happens to a person with the disease

The bacteria Corynebacterium diphtheria causes diphtheriaIt manifests as a skin condition as well as a respiratory infection. A person may contract diphtheria from a patient when the patient sneezes. In cutaneous infections, contact with the wound can lead to a skin as well as a respiratory infection. 

The good news in all this is that DTaP vaccines are quite effective in preventing an infection even if you come in contact with a patient.

If a person contracts the disease, the first symptom usually appears as a sore throat. A child who has an infection is usually irritable, would refuse to feed, and would start coughing. However, the hallmark of diphtheria is a greyish film that may develop on the inside of the throat. This pseudomembrane is a result of a set of toxins produced by the bacteria.

In addition, the patient may present with low-grade fever, hoarseness of voice, headaches, a whistling sound while breathing and a pink discharge from the nose. There is swelling in the neck caused by cervical adenopathy, and this, in addition to the swollen membrane gives an appearance of a bull neck in the patient. 

An immediate antibiotic treatment along with isolation of the patient is warranted. However, if the person does not receive treatment in time, the chances of a fatal outcome are high. The death is usually caused because the patient is unable to breathe due to internal swelling of the pharynx and often chokes on the pseudomembrane. 

Risk factors and avoiding diphtheria


Diphtheria thrives and spreads easily in conditions of overcrowding, poor sanitation, lack of immunisation or compromised immunity. In such conditions, it is easy to get infected and pass on the infection to others. 

The best way to keep the infection at a bay is by immunising your child. Luckily, immunisation is compulsory in Singapore, so you need not worry much if your child has been immunised. That said, always keep a lookout for the symptoms if you spot them. 

The next thing you need to ensure is that the child's immunity is in an excellent shape. Ensure that he gets a nutritious diet every time he eats. Lastly, make sure that the house is clean, the rooms are airy and you child gets plenty of fresh air. And, if you suspect that your child is showing symptoms of diphtheria, don't delay in contacting your doctor.

Stay safe, Singapore. 

Also, read This Singapore dad shares his daughter’s journey with Kawasaki Disease…

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Written by

Anay Bhalerao

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