The Centers for Disease Control and Prevention (CDC) issued or updated travel notices for three countries in Africa and Asia experiencing outbreaks of diphtheria.
In Nigeria, seven states (Lagos, Osun, Sokoto, Zamfara, Katsina, Kano and Yobe states and the Federal Capital Territory have been affected.
According to the World Health Organization (WHO), Between week 19, 2022 and week 31, 2023, 4 160 suspected cases of diphtheria were reported from 27 states in Nigeria. Kano (3 233), Yobe (477), and Katsina (132) States have reported the most cases. A total of 137 deaths were recorded among confirmed cases (CFR 7.5%). Of suspected cases, 1 534 were confirmed, including 87 laboratory confirmed, 158 epidemiologically linked, and 1 289 clinically compatible.
In Guinea, outbreaks of diphtheria have been reported from several districts in the eastern part of the country–Kouroussa, Siguiri, Kankan and Mandiana.
WHO states: An outbreak of diphtheria has been reported in the Kankan region of Guinea since 4 July 2023. As of 27 August 2023, 117 suspected cases have been reported, including seven confirmed cases, all of whom have died. A total of 37 deaths have been recorded and 189 active contacts are being followed up. Of the reported cases, 59% are female. The 1-4 years age group is the most affected with 60 cases (51.3%). Siguiri District has reported the highest number of cases (100 cases, 85.5%).
Lastly, several provinces in northern Vietnam are experiencing outbreaks, namely Dien Bien, Ha Giang and Thai Nguyen.
CDC notes for travelers:
- Vaccination against diphtheria is essential to protect against disease. If you are traveling to an affected area, you should be up to date with your diphtheria vaccines. Before travel, discuss the need for a booster dose with your healthcare professional.
- Avoid contact with persons with symptoms of diphtheria, such as fever, sore throat, difficulty swallowing, change in voice, shortness of breath, weakness, or fatigue.
- Avoid touching the wounds of others.
- Cover your nose and mouth with a tissue when you cough or sneeze.
- Wash your hands often with soap and water.
- If you feel sick during travel, seek medical care immediately. If you are unvaccinated or not fully vaccinated against diphtheria and become sick after possible exposure to someone with diphtheria, it is important to start treatment as soon as possible.
- If you feel sick after returning from travel, seek medical care immediately. Tell your healthcare professional about your diphtheria vaccination status and your recent travel, including where you went and what you did.
Diphtheria is a serious infection caused by strains of Corynebacterium diphtheriae bacteria that make a toxin. The toxin can cause people to get very sick. Diphtheria bacteria spread from person to person through respiratory droplets, like from coughing or sneezing. People can also get sick from touching open sores or ulcers of people sick with diphtheria.
When the bacteria get into the respiratory system they can cause sore throat, mild fever, and swollen glands in the neck. The bacteria make a toxin that kills healthy tissues in the respiratory system and can make it difficult to breathe and swallow. The toxin can also cause heart, nerve, and kidney problems if it enters the bloodstream. Skin infections caused by C. diphtheriae typically consist of shallow ulcers (sores) and do not result in severe disease.
For some people, respiratory diphtheria can lead to death. Even with treatment, about 1 in 10 patients with respiratory diphtheria die. Without treatment, up to half of patients can die from the disease.
If you are unvaccinated or not fully vaccinated against diphtheria and may have been exposed, it is important to start treatment as soon as possible.
CDC recommends that everyone 2 months and older get vaccinated to protect against diphtheria.
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