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Revue Medicale Suisse Apr 2019Diphtheria is reappearing in a typical cutaneous form where pre-existing skin lesions (wounds or insect bites) become pustular and turn into painful non-healing ulcers....
Diphtheria is reappearing in a typical cutaneous form where pre-existing skin lesions (wounds or insect bites) become pustular and turn into painful non-healing ulcers. This form is more common among migrants and disadvantaged populations. Lesions can be caused by strains of toxigenic and non-toxigenic Corynebacteria and among them the famous Corynebacterium diphtheriae. In this paper we review diphtheria's clinical presentations and pathogenesis, as well as methods of diagnosis, treatment and prevention.
Topics: Corynebacterium diphtheriae; Diphtheria; Humans; Insect Bites and Stings; Skin
PubMed: 30969492
DOI: No ID Found -
Emerging Infectious Diseases 1998The massive reemergence of diphtheria in the Newly Independent States of the former Soviet Union marked the first large-scale diphtheria epidemic in industrialized... (Review)
Review
The massive reemergence of diphtheria in the Newly Independent States of the former Soviet Union marked the first large-scale diphtheria epidemic in industrialized countries in 3 decades. Factors contributing to the epidemic included a large population of susceptible adults; decreased childhood immunization, which compromised what had been a well-established childhood vaccination program; suboptimal socioeconomic conditions; and high population movement. The role of a change in the predominant circulating strains of Corynebacterium diphtheriae in this epidemic remains uncertain. Massive, well-coordinated international assistance and unprecedented efforts to vaccinate adults were needed to control the epidemic.
Topics: Adult; Diphtheria; Humans; USSR
PubMed: 9866730
DOI: 10.3201/eid0404.980404 -
CMAJ : Canadian Medical Association... Jan 2021
Topics: Aged; Canada; Corynebacterium diphtheriae; Cough; Diphtheria; Emergency Service, Hospital; Fatal Outcome; Humans; India; Male; Travel
PubMed: 33397635
DOI: 10.1503/cmaj.200707 -
The Journal of Infectious Diseases Feb 2000After nearly two decades without a diphtheria case in Latvia, the disease reappeared in 1986. From 1990 to 1996, case counts were highest among adults 40-49 years of...
After nearly two decades without a diphtheria case in Latvia, the disease reappeared in 1986. From 1990 to 1996, case counts were highest among adults 40-49 years of age, school-aged children, and adolescents. Nonetheless, the average annualized incidence of disease was highest among infants and preschoolers. In August 1995, mass vaccination efforts began to provide adults 25-60 years of age with at least one dose of vaccine. By the end of the year, a 77% coverage rate was achieved, resulting in a decrease of reported diphtheria cases by 1996. From February to September 1997, special outreach efforts were focused on hard-to-reach populations; as a result, by June 1997, 55% of adults had received three doses of vaccine. While decreases in the incidence of and morbidity from diphtheria have occurred, additional efforts still need to be concentrated on improving vaccination coverage in adults and children <2 years of age and in reducing mortality from diphtheria.
Topics: Adolescent; Adult; Age Distribution; Child; Child, Preschool; Corynebacterium diphtheriae; Diphtheria; Diphtheria Toxoid; Disease Notification; Disease Outbreaks; Humans; Immunization; Immunization Programs; Incidence; Infant; Infant, Newborn; Latvia; Middle Aged; National Health Programs
PubMed: 10657192
DOI: 10.1086/315540 -
International Journal of Dermatology Dec 1991
Topics: Anti-Bacterial Agents; Corynebacterium diphtheriae; Diagnosis, Differential; Diphtheria; Ecthyma; Humans; Skin Diseases, Infectious
PubMed: 1816125
DOI: 10.1111/j.1365-4362.1991.tb04348.x -
The Journal of Infectious Diseases Oct 2001Diphtheria remains endemic in developing countries, but there are limited published data on the subject. Thailand's diphtheria surveillance data are relatively complete...
Diphtheria remains endemic in developing countries, but there are limited published data on the subject. Thailand's diphtheria surveillance data are relatively complete and may give a fuller picture of the situation in similar countries. After routine immunization began in 1977, the incidence of reported diphtheria decreased by >98% to <0.1 case per 100,000 persons annually in the 1990s. Despite infant immunization coverage of >90%, diphtheria cases were reported throughout the 1990s, primarily among children <15 years old. Outbreaks were linked to both persistent endemic circulation and to importation of toxigenic Corynebacterium diphtheriae; suboptimal immunization coverage in minority and disadvantaged groups contributed. A serologic survey found 25% of adults 20-39 years old and 14% of adolescents 10-19 years old lacked immunity to diphtheria; these data indicate an accumulation of susceptible adolescents and adults. Diphtheria remains a threat in Thailand; improvements in diphtheria control will depend on improving childhood immunization coverage in Thailand and the surrounding region.
Topics: Adolescent; Child; Diphtheria; Diphtheria Toxoid; Diphtheria-Tetanus-Pertussis Vaccine; Disease Outbreaks; Geography; Humans; Incidence; Infant; Thailand
PubMed: 11574919
DOI: 10.1086/323453 -
Communicable Diseases Intelligence Jun 1997
Topics: Australia; Corynebacterium diphtheriae; Diphtheria; Humans; Immunization; Incidence
PubMed: 9198303
DOI: No ID Found -
HSMHA Health Reports Dec 1971
Topics: Adult; Black or African American; Alabama; Carrier State; Child; Child, Preschool; Corynebacterium diphtheriae; Diagnosis, Differential; Diphtheria; Disease Outbreaks; Female; Humans; Immunization; Infant; Male; Middle Aged; Streptococcal Infections
PubMed: 5003360
DOI: No ID Found -
Emerging Infectious Diseases Jul 2018In February 2017, a diphtheria outbreak occurred among Amerindians of the Pemón ethnic group in Wonken, Venezuela. A field investigation revealed ≈10 cases; clinical...
In February 2017, a diphtheria outbreak occurred among Amerindians of the Pemón ethnic group in Wonken, Venezuela. A field investigation revealed ≈10 cases; clinical presentation did not include cutaneous or neurologic signs or symptoms. To prevent future outbreaks in Venezuela, Amerindian communities need better access to vaccination and healthcare.
Topics: Adult; Corynebacterium diphtheriae; Diphtheria; Disease Outbreaks; Female; Geography, Medical; History, 21st Century; Humans; Male; Population Surveillance; Venezuela
PubMed: 29912686
DOI: 10.3201/eid2407.171712 -
Annales de Dermatologie Et de... Mar 2021Diphtheria due to Corynebacteriumdiphtheriae (C. diphtheriae) has become rare in developed countries. In France only 10 cases of toxigenic diphtheria have been reported...
INTRODUCTION
Diphtheria due to Corynebacteriumdiphtheriae (C. diphtheriae) has become rare in developed countries. In France only 10 cases of toxigenic diphtheria have been reported since 1989, in all cases causing pharyngitis and all emanating from endemic countries with exception of one contact case. We report herein 13 cases with cutaneous diphtheria, in 5 of which diphtheria toxin was produced, and all imported into France between 2015 and 2018.
OBSERVATIONS
Thirteen patients aged 4 to 77 years presented painful and rapidly progressive round ulcerations of the legs, that were superficial and in some cases purulent, with an erythematous-purple border covered with greyish membrane. Bacteriological sampling of ulcers revealed the presence of C. diphtheriae. Only 6 patients had been properly immunized over the preceding 5 years.
DISCUSSION
These cases underline the resurgence of cutaneous diphtheria and the circulation of toxigenic strains in France following importation from Indian Ocean countries. This may constitute an important reservoir for ongoing transmission of the disease. Re-emergence of this pathogen stems from the current migratory flow and decreased adult booster coverage.
CONCLUSION
Cutaneous diphtheria should be considered in cases of rapidly developing painful skin ulcers with greyish membrane, especially among patients returning from endemic areas, regardless of their vaccination status. The clinician should order specific screening for C. diphtheriae from the bacteriologist, since with routine swabbing Corynebacteriaceae may be reported simply as normal skin flora. Vaccination protects against toxigenic manifestations but not against actual bacterial infection. Early recognition and treatment of cutaneous diphtheria and up-to-date vaccination are mandatory to avoid further transmission and spread of both cutaneous and pharyngeal diphtheria.
Topics: Adult; Diphtheria; Humans; Indian Ocean; Skin; Skin Ulcer; Ulcer
PubMed: 32631628
DOI: 10.1016/j.annder.2020.04.024