Diphtheria fatality reported in unvaccinated Antwerp, Belgium child

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An unvaccinated young child in Antwerp, Belgium died from diphtheria last week, according to Belgian health officials Thursday.

The 3-year-old girl was presented with symptoms on Mar. 6 and was admitted to intensive care five days later. The diagnosis with diphtheria was made on Mar. 15.

The National Institute for Public Health and the Environment (RIVM), the Netherlands, supplied the anti-toxin on 16 March. The child died on 17 March.

Diphtheria is a dangerous respiratory disease is caused by a potent toxin produced by certain strains of the bacterium Corynebacterium diphtheriae. Diphtheria is extremely contagious through coughing or sneezing. Risk factors include crowding, poor hygiene, and lack of immunization.

Symptoms usually appear within a week of infection. This infection is characterized by a sore throat, coughing and fever very similar to many common diseases like strep throat. Additional symptoms may be bloody, watery discharge from the nose and rapid breathing. However, a presumptive diagnosis can be made by observing a characteristic thick grayish patch (membrane) found in the throat. In more severe cases, neck swelling and airway obstruction may be observed. In the tropics, cutaneous and wound diphtheria is much more common and can be a source of transmission.

The real serious danger is when the toxin that is produced by the bacterium gets into the bloodstream and spreads to organs like the heart and nervous system. Myocarditis,congestive heart failure and neurological illnesses of paralysis that mimic Guillain-Barre syndrome are most severe. Even with treatment, fatalities are still seen in up to 10% of cases.

Diphtheria can be treated and cured successfully with antitoxin and antibiotics if started early enough. The prevention of diphtheria is through vaccination.

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