Abstract
Diphtheritic polyneuropathy is a vaccine-preventable illness caused by exotoxin-producing strains of Corynebacterium diphtheriae. We present a retrospective convenience case series of 15 children (6 girls) <15 years of age (mean age 5.2 years, case-fatality rate 53%, and 1 additional case-patient who was ventilator dependent at the time of last follow-up; median follow-up period 60 days) with signs and symptoms suggestive of diphtheritic polyneuropathy. All cases were identified through national acute flaccid paralysis surveillance, which was designed to detect poliomyelitis in India during 2002–2008. We also report data on detection of diphtheritic polyneuropathy compared with other causes of acute flaccid paralysis identified by this surveillance system.
Highlights
Diphtheritic polyneuropathy is a vaccine-preventable illness caused by exotoxin-producing strains of Corynebacterium diphtheriae
We report a case series of diphtheritic polyneuropathy in children in India identified by routine screening for acute flaccid paralysis (AFP), which was performed to achieve eradication of poliomyelitis in India
Our study demonstrates that diphtheritic neuropathy can be detected through existing AFP surveillance systems designed to detect poliomyelitis and may be pragmatically expanded to include diphtheritic neuropathy in children
Summary
India produces and exports diphtheria antitoxin, but local patients are often unable to pay for this therapy [20,23]
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