1887

Abstract

In Western Europe, the incidence of both respiratory and cutaneous diphtheria, caused by toxin-producing , or , has been low over the past few decades thanks to the use of an effective vaccine and a high level of vaccination coverage. However, the disease has still not been eradicated and continues to occur in all of Europe. In order to prevent sequelae or a fatal outcome, diphtheria antitoxin (DAT) should be administered to suspected diphtheria patients as soon as possible, but economic factors and issues concerning regulations have led to poor availability of DAT in many countries. The European Centre for Disease Prevention and Control and World Health Organization have called for European Union-wide solutions to this DAT-shortage. In order to illustrate the importance of these efforts and underline the need for continued diphtheria surveillance, we present data on all registered cases of toxigenic and non-toxigenic , and in Belgium during the past decade, up to and including 2017.

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2019-10-01
2019-10-15
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References

  1. Commission Implementing Decision of 8 August 2012 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council. 2011
  2. Wagner KS, White JM, Lucenko I, Mercer D, Crowcroft NS et al. Diphtheria in the postepidemic period, Europe, 2000-2009. Emerg Infect Dis 2012;18:217–225 [CrossRef]
    [Google Scholar]
  3. König C, Meinel DM, Margos G, Konrad R, Sing A. Multilocus sequence typing of Corynebacterium ulcerans provides evidence for zoonotic transmission and for increased prevalence of certain sequence types among toxigenic strains. J Clin Microbiol 2014;52:4318–4324 [CrossRef]
    [Google Scholar]
  4. Dazas M, Badell E, Carmi-Leroy A, Criscuolo A, Brisse S. Taxonomic status of Corynebacterium diphtheriae biovar Belfanti and proposal of Corynebacterium belfantii sp. nov. Int J Syst Evol Microbiol 2018;68:3826–3831 [CrossRef]
    [Google Scholar]
  5. Agentschap Zorg & Gezondheid Richtlijn infectieziektebestrijding Vlaanderen – difterie. LCI 07.2010, herzien 11.2013. Vlaamse versie: 06.. 2018
  6. Both L, White J, Mandal S, Efstratiou A. Access to diphtheria antitoxin for therapy and diagnostics. Euro Surveill 2014;19:20830 [CrossRef]
    [Google Scholar]
  7. Wagner KS, Stickings P, White JM, Neal S, Crowcroft NS et al. A review of the international issues surrounding the availability and demand for diphtheria antitoxin for therapeutic use. Vaccine 2009;28:14–20 [CrossRef]
    [Google Scholar]
  8. European Centre for Disease Prevention and Control Gap Analysis on Securing Diphtheria Diagnostic Capacity and Diphtheria Antitoxin Availability in the EU/EEA Stockholm: ECDC; 2017
    [Google Scholar]
  9. Jané M, Vidal MJ, Camps N, Campins M, Martínez A et al. A case of respiratory toxigenic diphtheria: contact tracing results and considerations following a 30-year disease-free interval, catalonia, spain, 2015. Euro Surveill 2018;23: [CrossRef]
    [Google Scholar]
  10. European Centre for Disease Prevention and Control A Fatal Case of Diphtheria in Belgium2016 Stockholm: ECDC; 2016
    [Google Scholar]
  11. Bennett JE, Dolin R, Mandell BMJ. Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 8th ed. Chap. 206 by Rob Roy MacGregor; 2015
    [Google Scholar]
  12. Lodeiro-Colatosti A, Reischl U, Holzmann T, Hernández-Pereira CE, Rísquez A et al. Diphtheria outbreak in amerindian communities, wonken, venezuela, 2016–2017. Emerg Infect Dis 2018;24:1340–1344 [CrossRef]
    [Google Scholar]
  13. Dureab F, Müller O, Jahn A. Resurgence of diphtheria in yemen due to population movement. J Travel Med 2018;25: [CrossRef]
    [Google Scholar]
  14. World Health Organization Who vaccine-preventable diseases: monitoring system 2018 global summary. http://apps.who.int/immunization_monitoring/globalsummary/ timeseries /tsincidencediphtheria.html on 25 March 2019
  15. Galazka A, Dittmann S. The changing epidemiology of diphtheria in the vaccine era. J Infect Dis 2000;181:S2–S9 [CrossRef]
    [Google Scholar]
  16. Both L, Collins S, de Zoysa A, White J, Mandal S et al. Molecular and epidemiological review of toxigenic diphtheria infections in England between 2007 and 2013. J Clin Microbiol 2015;53:567–572 [CrossRef]
    [Google Scholar]
  17. WHO Immunization, vaccines and biologicals: data, statistics and graphics.. 2017
  18. Kanitz EE, Wu LA, Giambi C, Strikas RA, Levy-Bruhl D et al. Variation in adult vaccination policies across Europe: an overview from Venice network on vaccine recommendations, funding and coverage. Vaccine 2012;30:5222–5228 [CrossRef]
    [Google Scholar]
  19. Weinberger B. Adult vaccination against tetanus and diphtheria: the European perspective. Clin Exp Immunol 2017;187:93–99 [CrossRef]
    [Google Scholar]
  20. Caboré R, Piérard D, Huygen K. A belgian serosurveillance/seroprevalence study of diphtheria, tetanus and pertussis using a luminex xMAP technology-based pentaplex. Vaccines 2016;4:16 [CrossRef]
    [Google Scholar]
  21. Theeten H, Hutse V, Hens N, Yavuz Y, Hoppenbrouwers K et al. Are we hitting immunity targets? the 2006 age-specific seroprevalence of measles, mumps, rubella, diphtheria and tetanus in Belgium. Epidemiol Infect 2011;139:494–504 [CrossRef]
    [Google Scholar]
  22. Hauser D, Popoff MR, Kiredjian M, Boquet P, Bimet F et al. Polymerase chain reaction assay for diagnosis of potentially toxinogenic Corynebacterium diphtheriae strains: correlation with ADP-ribosylation activity assay. J Clin Microbiol 1993;31:2720–2723
    [Google Scholar]
  23. Khamis A, Raoult D, La Scola B. rpoB gene sequencing for identification of Corynebacterium species. J Clin Microbiol 2004;42:3925–3931 [CrossRef]
    [Google Scholar]
  24. De Zoysa A, Efstratiou A, Mann G, Harrison TG, Fry NK. Development, validation and implementation of a quadruplex real-time PCR assay for identification of potentially toxigenic corynebacteria. J Med Microbiol 2016;65:1521–1527 [CrossRef]
    [Google Scholar]
  25. Engler KH, Glushkevich T, Mazurova IK, George RC, Efstratiou A et al. A modified Elek test for detection of toxigenic corynebacteria in the diagnostic laboratory. J Clin Microbiol 1997;35:495–498
    [Google Scholar]
  26. The European committee on antimicrobial susceptibility testing 2016; Breakpoint tables for interpretation of MICs and zone diameters, version 6.0. http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_6.0_Breakpoint_table.pdf
  27. CLSI Performance standards for antimicrobial susceptibility testing; approved standard, M100-S26, vol. 30 No. 1.. 2011;30
  28. Bolt F, Cassiday P, Tondella ML, Dezoysa A, Efstratiou A et al. Multilocus sequence typing identifies evidence for recombination and two distinct lineages of Corynebacterium diphtheriae. J Clin Microbiol 2010;48:4177–4185 [CrossRef]
    [Google Scholar]
  29. Jolley KA, Maiden MCJ. BIGSdb: scalable analysis of bacterial genome variation at the population level. BMC Bioinformatics 2010;11: [CrossRef]
    [Google Scholar]
  30. Detemmerman L, Rousseaux D, Efstratiou A, Schirvel C, Emmerechts K et al. Toxigenic Corynebacterium ulcerans in human and non-toxigenic Corynebacterium diphtheriae in cat. New Microbes New Infect 2013;1:18–19 [CrossRef]
    [Google Scholar]
  31. Mel’nikov VG, Slu K, Olu B, Volozhantsev NV, Verevkin VV et al. Corynebacterium diphtheriae nontoxigenic strain carrying the gene of diphtheria toxin. Zh Mikrobiol Epidemiol Immunobiol 2004;3–7. Russian
    [Google Scholar]
  32. Zakikhany K, Neal S, Efstratiou A. Emergence and molecular characterisation of non-toxigenic tox gene-bearing Corynebacterium diphtheriae biovar mitis in the United Kingdom, 2003-2012. Euro Surveill 2014;19:20819 [CrossRef]
    [Google Scholar]
  33. Van Damme K, Peeters N, Jorens PG, Boiy T, Deplancke M et al. Fatal diphtheria myocarditis in a 3-year-old girl-related to late availability and administration of antitoxin?. Paediatr Int Child Health 2017;29:1–5
    [Google Scholar]
  34. Konrad R, Hörmansdorfer S, Sing A. Possible human-to-human transmission of toxigenic Corynebacterium ulcerans. Clin Microbiol Infect 2015;21:768–771 [CrossRef]
    [Google Scholar]
  35. Kneen R, Pham NG, Solomon T, Tran TM, Nguyen TT et al. Penicillin vs. erythromycin in the treatment of diphtheria. Clin Infect Dis 1998;27:845–850 [CrossRef]
    [Google Scholar]
  36. Rajamani Sekar SK, Veeraraghavan B, Anandan S, Devanga Ragupathi NK, Sangal L et al. Strengthening the laboratory diagnosis of pathogenic Corynebacterium species in the Vaccine era. Lett Appl Microbiol 2017;65:354–365 [CrossRef]
    [Google Scholar]
  37. Courvalin P, Leclercq R, Riegel Philippe. editor Antibiogramme, 3rd. 2012
    [Google Scholar]
  38. Maple PA, Efstratiou A, Tseneva G, Rikushin Y, Deshevoi S et al. The in-vitro susceptibilities of toxigenic strains of Corynebacterium diphtheriae isolated in northwestern Russia and surrounding areas to ten antibiotics. J Antimicrob Chemother 1994;34:1037–1040 [CrossRef]
    [Google Scholar]
  39. Zamiri I, McEntegart MG. The sensitivity of diphtheria bacilli to eight antibiotics. J Clin Pathol 1972;25:716–717 [CrossRef]
    [Google Scholar]
  40. Kantsone I, Lucenko I, Perevoscikovs J. More than 20 years after re-emerging in the 1990s, diphtheria remains a public health problem in Latvia. Euro Surveill 2016;21: [CrossRef]
    [Google Scholar]
  41. Wagner KS, White JM, Crowcroft NS, De Martin S, Mann G et al. Diphtheria in the United Kingdom, 1986–2008: the increasing role of Corynebacterium ulcerans. Epidemiol Infect 2010;138:1519–1530 [CrossRef]
    [Google Scholar]
  42. Meinel DM, Kuehl R, Zbinden R, Boskova V, Garzoni C et al. Outbreak investigation for toxigenic Corynebacterium diphtheriae wound infections in refugees from Northeast Africa and Syria in Switzerland and Germany by whole genome sequencing. Clin Microbiol Infect 2016;22:1003.e1–101003 [CrossRef]
    [Google Scholar]
  43. European Centre for Disease Prevention and Control Cutaneous Diphtheria Among Recently Arrived Refugees and Asylum Seekers in the EU Stockholm: ECDC; 2015
    [Google Scholar]
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