The diphtheria outbreak in Venezuela that began in July 2016 continues.

1,904 suspected diphtheria cases reported, including 164 deaths: 324 cases and 17 deaths in 2016, 1,040 cases and 103 deaths in 2017, and 540 cases and 44 deaths through the halfway mark of 2018.

Image/Robert Herriman
Image/Robert Herriman

Of note, in 2016, cases were reported in 5 states (Anzoátegui, Bolívar, Delta Amacuro, Monagas, and Sucre), while in 2017 and 2018, 22 states and the Capital District reported confirmed cases.

Cases have been reported among all age groups. In 2018 the incidence rate per 100,000 inhabitants was higher in those under 15-years-old than those over 15-years-old.

Diphtheria: A short history, the disease, treatment and the success of the vaccines

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.

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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.

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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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