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. Last Updated: 07/27/2016

Diphtheria Concentrated in High Risk Groups

Most of the hundreds of diphtheria patients Dr. Valeria Baranova has treated at Moscow's Hospital No. 2 this year have been train station workers, hairdressers, street vendors, teachers - people who spend a lot of time in public places.


"A babushka sitting at home is unlikely to get this disease", said Baranova, who runs one of Moscow's three diphtheria wards, although she added that anyone who has not been immunized can catch diphtheria.


In an interview at the hospital Tuesday, Baranova said the situation is "horrible", referring to a diphtheria epidemic that is spreading throughout Russia's major cities.


Baranova and two other doctors who treat the ward's 60 patients fear that a bed shortage could soon arise because Muscovites are still reluctant to inoculate themselves and their children against the disease.


Diphtheria attacks mucous membranes, causing difficulty in breathing, high fever and can prove fatal. It has contaminated 3, 702 Russians in the first six months of this year, according to officials at the Geneva-based World Health Organization.


That is up from 3, 867 cases in all of 1992 and compares to just three registered cases last year in the United States and one case in England.


Diphtheria is highly contagious since it is spread through air and has contaminated some 900 people in Moscow this year, 47 of whom have died. Fifty soldiers in the Siberian region of Khakassia have become the latest victims of the disease, Reuters said Tuesday.


Unlike cholera which has mostly affected inhabitants of the southern republics of the former Soviet Union, WHO experts said Monday that the cities of Moscow, St. Petersburg, Kaliningrad and Orlov have been worst hit by diphtheria.


Baranova said the epidemic will continue to get worse for several years to come, because Muscovites still believe inoculation can have hazardous effects or cause allergic reactions.


"We even have patients who get terribly ill and after they recover they go home and don't bother getting inoculated", said Yelena Petrova, a research doctor at Hospital No. 2. "People believe that they will get other illnesses from the vaccine and therefore prefer to take the risk than get a shot".


Sitting in a run-down room next to the women's diphtheria ward, with dirty floors and water dripping from the ceiling, Petrova said conditions in the hospital were "manageable, but not always desirable".


The ward is filled to capacity, with four patients to a room. Baranova said the hospital should have been closed for renovations two years ago, but that the influx of infectious diseases, especially diphtheria, has made this impossible.


"Just look at this place", Petrova said, pointing at the crumbling paint on the walls. "But we can't close because that would create a catastrophic situation".


Igor Nadezhdin, spokesman for the city health department, said that the cost of treating a diphtheria patient can be up to 300, 000 rubles, or $300 a day and that the only medicine which helps is horse serum that needs to bought for hard currency in the West. So far, Baranova said, there has been no shortage of medicine.


Most serious cases are heavy drinkers, according to Baranova. Usually they contract the disease by sharing a bottle of vodka with fellow drinkers. She said that their low level of immunity, broken down by alcohol, makes them more susceptible to diphtheria - and more likely to die from it.


Baranova said that most of her patients, who range between the ages of 15 and 80, fear returning to school or work after they have recovered because they are treated with hostility by others who are afraid of becoming infected.


"We have to do a lot of psychological work with the patients", said Baranova, who added that most patients spend between a month and 120 days in the ward.


"But there is no reason why people should have to suffer", she added. "They should just get inoculated and get a booster shot every 10 years. If they do that then we can eradicate the problem just like we did in the '60s".