Diphtheria’s ominous return sparks global health concerns

GUINEA — Diphtheria, a severe bacterial infection caused by Corynebacterium diphtheriae, has reemerged as a critical global health concern.

Recent outbreaks have prompted health authorities to take immediate action to control its spread.

In Guinea, the WHO has reported a diphtheria outbreak that began in the Kankan region on July 4. Since its onset, a total of 117 suspected cases have been reported, with seven confirmed cases among them.

Tragically, the outbreak has claimed 37 lives, including all confirmed cases, with nearly a quarter of the deaths occurring within the community. Currently, health officials are monitoring 189 active contacts to contain the outbreak.

Notably, the Siguiri District in the Kankan region has been the hardest hit, accounting for a staggering 85.5% of all reported cases (100). The outbreak’s severity in this region highlights the urgency of intervention efforts.

Guinea faces additional challenges due to suboptimal vaccination coverage. A recent survey indicated that the routine immunization coverage for the third dose of the pentavalent vaccine, which includes diphtheria protection, was a mere 47% in 2022.

The situation is even bleaker in the Kankan region, exacerbating the risk of outbreaks.

North Africa is also grappling with its diphtheria challenge, as Algeria’s Ministry of Health declared a state of emergency to combat an outbreak in southern regions.

As of August 3, Algeria reported 80 cases, including 16 confirmed instances of diphtheria. This resurgence of the disease raises concerns about the ability to control its transmission effectively.

Diphtheria is a bacterial infection that predominantly affects the mucous membranes of the nose and throat, and sometimes the skin.

Its name originates from the characteristic tough pseudomembrane that forms in the patient’s throat, causing respiratory distress.

The bacteria responsible for diphtheria are primarily transmitted through respiratory droplets, making it highly contagious.

Infected individuals can spread the disease through coughing, sneezing, or even laughing. It can also be contracted by touching contaminated surfaces or coming into contact with the skin form of diphtheria.

The bacteria produce a potent toxin that leads to illness, underscoring the importance of vaccination as a preventive measure.

Historically, diphtheria posed a grave threat, with the United States alone recording a staggering 206,000 cases in 1921, resulting in 15,520 deaths.

However, the advent of diphtheria vaccines, introduced in the 1920s and 1930s and followed by universal childhood vaccination in the late 1940s, led to effective control of the disease. Diphtheria became a rarity in the United States, with very few reported cases.

Nevertheless, diphtheria remains a global health challenge, with sporadic outbreaks reported in recent years.

Nigeria, for instance, has been battling a significant outbreak since the beginning of the year, reporting 4,160 suspected cases, including 1,534 confirmed cases, between May 2022 and July 2023. Tragically, this outbreak has claimed 137 lives, emphasizing the lethal potential of the disease.

Alarmingly, despite the availability of safe and cost-effective vaccines, the majority of confirmed diphtheria cases in Nigeria’s ongoing outbreak—82% to be exact—were among unvaccinated individuals.

Such a resurgence prompted the Centers for Disease Control and Prevention (CDC) to issue a travel advisory for Nigeria.

Vaccination against diphtheria is crucial to preventing outbreaks and protecting public health. The diphtheria toxoid vaccine is considered one of the safest available.

Individuals with an anti-diphtheria toxin antibody level exceeding 0.1 IU/mL are considered fully protected from the disease.

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