Increase in cases of diphtheria in centers…

As of September 26, 2022, 92 cases of diphtheria in migrants, including one fatality, have been reported this year by seven European countries – Austria, Germany, United Kingdom, Norway, Belgium, France and Switzerland. All the cases are men, mostly from Asia and Africa, and most of them were diagnosed in migrant reception centres.

L’European Center for Disease Prevention and Control (ECDC) has carried out a risk assessment regarding the overall risk posed by reported diphtheria cases in the EU/EEA to wider communities and specific populations exposed to migrant reception centres.

In its recent report, the ECDC considers the overall risk to be very low for the general EU/EEA population, considering the likelihood of infection and the impact of the disease. Given the estimated high vaccination coverage against diphtheria, tetanus and pertussis (DTP) in EU/EEA countries, ranging from 91% to 99% for the first dose (DTP1), over the three doses of a complete cycle of vaccination, and 85% to 99% for the third dose (DTP3), the probability that people residing in the community develop the disease is very low. Nevertheless, the possibility of secondary infections in the community cannot be excluded and severe clinical diphtheria is possible in unvaccinated or immunocompromised persons.

Regarding persons residing, working or volunteering in migrant centers, there is a moderate likelihood of exposure to diphtheria bacteria. Exposed, unvaccinated, or immunocompromised individuals may face a serious outcome after diphtheria infection. However, the impact of disease for people with a full diphtheria vaccination schedule is considered low.

Reminders on the diphtheria.

The diphtheria is a highly contagious disease caused by Corynebacterium of the diphtheriae complex, which includes the species Corynebacterium diphtheriaeCorynebacterium ulcerans et Corynebacterium pseudotuberculosis. These three species of bacteria are capable of producing diphtheria toxin. This toxin is essentially responsible for the clinical manifestations.

The mode of transmission is by air during direct contact with patients or healthy carriers through aerosols emitted by coughing and sneezing.

The incubation period for diphtheria is usually 2 to 5 days. The most characteristic symptom of this disease is the presence of whitish “false membranes” in the tonsils or in the wound.

  • Diphtheria angina is the usual form of the disease. It is characterized by pharyngitis, fever, neck swelling and headache. In some cases the toxin can lead to paralysis of the central nervous system or of the diaphragm and throat leading to death by asphyxiation.
  • There is also a cutaneous form with chronic wounds.

Source : European Center for Disease Prevention and Control (ECDC)

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