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La Revue de Medecine Interne Jan 1999Diphtheria is a reemerging disease. Two epidemics recently occurred in Algeria and Independent States Community, not so far from Europe. Imported cases were diagnosed in... (Review)
Review
INTRODUCTION
Diphtheria is a reemerging disease. Two epidemics recently occurred in Algeria and Independent States Community, not so far from Europe. Imported cases were diagnosed in contiguous European countries. This review focuses on the data obtained from these epidemics, with particular emphasis on new clinical forms of Corynebacterium diphtheriae infections. CURRENTS KNOWLEDGE AND KEY POINTS: Sore throat with membranes is no longer the only clinical feature of diphtheria. However, patients' management is identical, with combination of antibiotics, injection of specific antisera, and immunization of patients' close contacts and relatives. French and American sero-epidemiological studies showed that antibody levels does not provide protection, particularly in the elderly. Adult populations would therefore be at risk every 10 years. Recent advances in molecular biology led to the development of gene amplification with polymerase chain reaction, that may be used for the detection of the toxin gene. They also promoted epidemiological surveys of circulating strains via ribotyping. Although this technic evidenced predominant strains in the various countries, genotypes encountered during an epidemics may differ. Besides diphtheria which has apparently been eradicated in France, systemic infections with non-toxigenic strains of C diphtheriae, such as endocarditis, septicemia and arthritis, are evenly diagnosed.
FUTURE PROSPECTS AND PROJECTS
A French national reference center for C diphtheriae has been recently created. This center collects most of the strains isolated in France, clinical data and assesses the toxigenicity of bacteria, allowing strict epidemiological survey.
Topics: Adult; Aged; Algeria; Anti-Bacterial Agents; Antibodies, Bacterial; Commonwealth of Independent States; Corynebacterium Infections; Corynebacterium diphtheriae; Diphtheria; Diphtheria Toxoid; Disease Outbreaks; Europe; Genotype; Humans; Risk Factors; Seroepidemiologic Studies
PubMed: 10220818
DOI: 10.1016/s0248-8663(99)83007-0 -
The Medical Journal of Australia Mar 2023
Topics: Humans; Diphtheria; Queensland; Corynebacterium diphtheriae
PubMed: 36806213
DOI: 10.5694/mja2.51858 -
Euro Surveillance : Bulletin Europeen... Nov 2022From July 2022, cases of imported diphtheria with toxigenic remarkably increased among migrants arriving in Germany. Up to 30 September 2022, 44 cases have been...
From July 2022, cases of imported diphtheria with toxigenic remarkably increased among migrants arriving in Germany. Up to 30 September 2022, 44 cases have been reported to the national public health institute, all laboratory-confirmed, male, and mainly coming from Syria (n = 21) and Afghanistan (n = 17). Phylogeny and available journey information indicate that most cases (n = 19) were infected along the Balkan route. Active case finding, increased laboratory preparedness and epicentre localisation in countries along this route are important.
Topics: Male; Humans; Corynebacterium diphtheriae; Diphtheria; Transients and Migrants; Corynebacterium; Disease Outbreaks; Germany
PubMed: 36398576
DOI: 10.2807/1560-7917.ES.2022.27.46.2200849 -
Emerging Infectious Diseases Aug 2023Corynebacterium ulcerans is a closely related bacterium to the diphtheria bacterium C. diphtheriae, and some C. ulcerans strains produce toxins that are similar to... (Review)
Review
Corynebacterium ulcerans is a closely related bacterium to the diphtheria bacterium C. diphtheriae, and some C. ulcerans strains produce toxins that are similar to diphtheria toxin. C. ulcerans is widely distributed in the environment and is considered one of the most harmful pathogens to livestock and wildlife. Infection with C. ulcerans can cause respiratory or nonrespiratory symptoms in patients. Recently, the microorganism has been increasingly recognized as an emerging zoonotic agent of diphtheria-like illness in Japan. To clarify the overall clinical characteristics, treatment-related factors, and outcomes of C. ulcerans infection, we analyzed 34 cases of C. ulcerans that occurred in Japan during 2001-2020. During 2010-2020, the incidence rate of C. ulcerans infection increased markedly, and the overall mortality rate was 5.9%. It is recommended that adults be vaccinated with diphtheria toxoid vaccine to prevent the spread of this infection.
Topics: Adult; Humans; Diphtheria; Japan; Corynebacterium; Corynebacterium Infections; Corynebacterium diphtheriae; Diphtheria Toxin; Diphtheria Toxoid
PubMed: 37486266
DOI: 10.3201/eid2908.220058 -
Epidemiology and Infection Mar 2015We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27 confirmed cases...
We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27 confirmed cases occurred in partially (n = 16) or completely (n = 10) immunized children (n = 26). Clinical signs and characteristic symptoms of diphtheria such as cervical lymphadenopathy and pseudomembrane formation were absent in 48% and 7% of the cases, respectively. Complications such as paralysis of lower limbs were observed. Three cases resulted in death, two of them in completely immunized children. Microbiological analysis identified the isolates as Corynebacterium diphtheriae biovar intermedius with a predominant PFGE type. Most of them were toxigenic and some showed a decrease in penicillin G susceptibility. In conclusion, diphtheria remains endemic in Brazil. Health professionals need to be aware of the possibility of atypical cases of C. diphtheriae infection, including pharyngitis without pseudomembrane formation.
Topics: Adolescent; Adult; Brazil; Child; Corynebacterium diphtheriae; Diphtheria; Disease Outbreaks; Drug Resistance, Bacterial; Electrophoresis, Gel, Pulsed-Field; Female; Humans; Male; Microbial Sensitivity Tests; Young Adult
PubMed: 25703400
DOI: 10.1017/S0950268814001241 -
Forensic Science, Medicine, and... Mar 2015
Topics: Airway Obstruction; Autopsy; Cause of Death; Child; Corynebacterium diphtheriae; Diphtheria; Fatal Outcome; Humans; Male; Pharynx; Respiratory System
PubMed: 25332174
DOI: 10.1007/s12024-014-9623-y -
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 -
Fortschritte Der Medizin Apr 1977
Topics: Ampicillin; Carrier State; Corynebacterium diphtheriae; Diphtheria; Diphtheria Toxoid; Erythromycin; Humans; Immunity; Oxacillin; Penicillins; Scarlet Fever; Tetracycline; Virulence
PubMed: 404227
DOI: No ID Found -
British Medical Journal Feb 1973
Topics: Alberta; Corynebacterium diphtheriae; Diphtheria; Humans; United Kingdom
PubMed: 4632127
DOI: 10.1136/bmj.1.5851.486-e -
Emerging Infectious Diseases Feb 2012Diphtheria incidence has decreased in Europe since its resurgence in the 1990s, but circulation continues in some countries in eastern Europe, and sporadic cases have...
Diphtheria incidence has decreased in Europe since its resurgence in the 1990s, but circulation continues in some countries in eastern Europe, and sporadic cases have been reported elsewhere. Surveillance data from Diphtheria Surveillance Network countries and the World Health Organization European Region for 2000-2009 were analyzed. Latvia reported the highest annual incidence in Europe each year, but the Russian Federation and Ukraine accounted for 83% of all cases. Over the past 10 years, diphtheria incidence has decreased by >95% across the region. Although most deaths occurred in disease-endemic countries, case-fatality rates were highest in countries to which diphtheria is not endemic, where unfamiliarity can lead to delays in diagnosis and treatment. In western Europe, toxigenic Corynebacterium ulcerans has increasingly been identified as the etiologic agent. Reduction in diphtheria incidence over the past 10 years is encouraging, but maintaining high vaccination coverage is essential to prevent indigenous C. ulcerans and reemergence of C. diphtheriae.
Topics: Adolescent; Adult; Child; Child, Preschool; Corynebacterium; Diphtheria; Epidemics; Europe; Female; Humans; Incidence; Infant; Male; Middle Aged; Population Surveillance; Vaccination; Young Adult
PubMed: 22304732
DOI: 10.3201/eid1802.110987