- Mireia Jané1,2, Maria José Vidal1, Neus Camps1, Magda Campins3, Ana Martínez1,2, Joan Balcells3, Maria Teresa Martin-Gomez3, Gloria Bassets4, Silvia Herrera-León5, Anton Foguet6, Mar Maresma1, Nuria Follia1, Sonia Uriona3, Tomàs Pumarola3
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View Affiliations Hide AffiliationsAffiliations: 1 Public Health Agency of Catalonia, Barcelona and Girona, Spain 2 CIBER Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Madrid, Spain 3 Vall d’Hebron University Hospital, Catalan Institute of Health, Barcelona, Spain 4 Centre d’Atenció Primària d’Olot, Catalan Institute of Health, Olot, Spain 5 National Microbiology Centre, Carlos III Institute of Health, Madrid, Spain 6 Fundació Hospital d’Olot i Comarcal de la Garrotxa, Olot, SpainMireia Janémireia.jane gencat.cat
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Citation style for this article: Jané Mireia, Vidal Maria José, Camps Neus, Campins Magda, Martínez Ana, Balcells Joan, Martin-Gomez Maria Teresa, Bassets Gloria, Herrera-León Silvia, Foguet Anton, Maresma Mar, Follia Nuria, Uriona Sonia, Pumarola Tomàs. 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(13):pii=17-00183. https://doi.org/10.2807/1560-7917.ES.2018.23.13.17-00183 Received: 09 Mar 2017; Accepted: 17 Aug 2017
A case of respiratory toxigenic diphtheria: contact tracing results and considerations following a 30-year disease-free interval, Catalonia, Spain, 2015
Abstract
In May 2015, following a 30-year diphtheria-free interval in Catalonia, an unvaccinated 6-year-old child was diagnosed with diphtheria caused by toxigenic Corynebacterium diphtheriae. After a difficult search for equine-derived diphtheria antitoxin (DAT), the child received the DAT 4 days later but died at the end of June. Two hundred and seventeen contacts were identified in relation to the index case, and their vaccination statuses were analysed, updated and completed. Of these, 140 contacts underwent physical examination and throat swabs were taken from them for analysis. Results were positive for toxigenic C. diphtheriae in 10 contacts; nine were asymptomatic vaccinated children who had been in contact with the index case and one was a parent of one of the nine children. Active surveillance of the 217 contacts was initiated by healthcare workers from hospitals and primary healthcare centres, together with public health epidemiological support. Lack of availability of DAT was an issue in our case. Such lack could be circumvented by the implementation of an international fast-track procedure to obtain it in a timely manner. Maintaining primary vaccination coverage for children and increasing booster-dose immunisation against diphtheria in the adult population is of key importance.

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