Rare Disease Report

Diphtheria Outbreak Afflicts Rohingya Refugee Camps

JANUARY 29, 2018
Kaitlynn Ely
As the Myanmar military’s genocidal actions continue to displace Rohingya refugees, the persecuted minority group is experiencing the largest diphtheria outbreak since the 1920s.

Myanmar is located in Southeast Asia, and borders India and Bangladesh. While most of the nation is Buddhist, the Rohingya are practicing Muslims who are not considered citizens of the state, and the human rights offenses committed by the Myanmar government began to increase about a decade ago, resulting in an estimated one million Rohingya people who have fled to Bangladesh since the 1970s.

National Public Radio (NPR), described the conditions the Rohingya lived in before the government crackdowns: “The Muslim minority have faced discrimination in schools and the workforce. They need permission from the government to leave their villages. Some were forced to live in camps. And this was all before the military started attacking them and burning their villages to the ground last year.”

Diphtheria is hardly seen in the West due to widespread vaccination in infants and children. According to the Centers for Disease Control (CDC), only 5 cases of diphtheria have been reported in the United States over the past decade. Yet close contact among refugees in camp tents have created 5,000 cases of the illness, resulting in 33 deaths.

The mortality rate has remained rather low, as public health officials and doctors have opened clinics and treatment centers that test patients daily. Dr. Andy Doyle, a physician with Samaritan’s Purse diphtheria treatment center in the Balukhali refugee camp, said in an interview with NPR that the main symptoms observed in patients include a high fever, a sore throat, a runny nose, and severe inflammation in the back of the throat.

"Sometimes they get swelling in their necks, especially in the younger children, and their neck itself will get really big," explained Dr. Doyle. "It's called bull neck. And those are the signs that the airway is in impending danger. So that's what we look for."

Patients diagnosed with diphtheria are often treated with antibiotics unless their airway is almost completely blocked by the swelling. Then, the doctors will administer an anti-toxin through an intravenous drop that has more serious side effects than the oral antibiotic. The anti-toxin can often spark a fatal allergic reaction in the patient.

Along with diphtheria, measles has also infected refugees in the camps. The United Nations along with public health officials believe that a lack of vaccinations within this community has caused these outbreaks to occur.

Humanitarian groups, like Doctors Without Borders, have started to immunize refugees in Bangladesh against highly contagious diseases. Nonetheless, these immunizations require a few shots spread out over time and will not stop the spread of diphtheria in Rohingya refugee camps anytime soon.

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