Diphtheria

2021 ◽  
Author(s):  
Timothy Chege Kuria
Keyword(s):  
Diphtheria Toxin ◽  
Observational Studies ◽  
Respiratory Infections ◽  
Case Fatality ◽  
Skin Lesions ◽  
Physical Contact ◽  
Skin Infections ◽  
Diphtheria Antitoxin ◽  
Local Reactions ◽  
Respiratory Droplets

Diphtheria is caused by toxin-producing bacteria, Corynebacterium diphtheriae, and less frequently by one of two other, zoonotic, Corynebacteria. Diphtheria toxin destroys tissue, which builds up in the throat and tonsils, making breathing and swallowing almost impossible. The bacteria are transmitted by respiratory droplets, by direct physical contact with skin lesions, via secretions from infected patients, or contaminated materials. Clinically, tonsillitis, pharyngitis, laryngitis, and skin infections (wound infection; ulcers) appear; diphtheria once was a terrible killer of young children. Antibiotics (penicillin, erythromycin, others) are used to eradicate the bacteria; for respiratory infections, diphtheria antitoxin is used to neutralize circulating toxins and reduce/prevent complications like myocarditis, neuritis (nerve palsies). Case fatality rates of up to 10% have been reported during diphtheria outbreaks, and are even higher in settings where diphtheria antitoxin is unavailable. Diphtheria vaccines consist of inactivated toxins, called toxoids, and are available in combinations with other antigens such as tetanus, pertussis, and others. These combinations are usually well-tolerated, local reactions are the most frequently observed side effects. Efficacy studies are not available but various observational studies consistently indicate high vaccine effectiveness between 87% and 96%.

Diphtheria

2020 ◽  
pp. 959-965
Author(s):  
Delia B. Bethell ◽  
Tran Tinh Hien
Keyword(s):  
Single Molecule ◽  
Diphtheria Toxin ◽  
Direct Contact ◽  
Upper Airway ◽  
Developed Countries ◽  
Skin Lesions ◽  
Eukaryotic Cell ◽  
Lethal Infection ◽  
Corynebacterium Diphtheria ◽  
Respiratory Droplets

Diphtheria is a potentially lethal infection caused by toxin-producing strains of Corynebacterium diphtheria, a Gram-positive bacillus. Humans are the only known reservoir, with spread via respiratory droplets or direct contact with skin lesions. Although now rare in developed countries, this vaccine-preventable disease remains an important problem in countries with poor or failing health systems, and is estimated to cause about 5,000 deaths per year worldwide, most in children under 5 years of age. Diphtheria develops when toxigenic bacteria lodge in the upper airway or on the skin of a susceptible individual. An intense inflammatory reaction develops, leading to a characteristic greyish-coloured pseudomembrane that is adherent to underlying tissues. Systemic effects are caused by release of diphtheria toxin, carried by a lysogenic corynebacteriophage, a single molecule of factor A of which can kill a eukaryotic cell.

THE 2019 NOVEL PANDEMIC OF CORONAVIRUS DISEASE (COVID-19): A STUDY OF EXISTING EVIDENCE IN THE INDIAN POPULATION

2020 ◽  
Vol 7 (2) ◽  
pp. 199-204
Author(s):  
Shrikant Verma ◽  
Mohammad Abbas ◽  
Sushma Verma ◽  
Syed Tasleem Raza ◽  
Farzana Mahdi
Keyword(s):  
Disease Transmission ◽  
Indian Population ◽  
Respiratory Infections ◽  
Clinical Signs ◽  
Case Fatality ◽  
Public Health Emergency ◽  
The World ◽  
And Control ◽  
General Wellbeing ◽  
Different Parts

A novel spillover coronavirus (nCoV), with its epicenter in Wuhan, China's People's Republic, has emerged as an international public health emergency. This began as an outbreak in December 2019, and till November eighth, 2020, there have been 8.5 million affirmed instances of novel Covid disease2019 (COVID-19) in India, with 1,26,611 deaths, resulting in an overall case fatality rate of 1.48 percent. Coronavirus clinical signs are fundamentally the same as those of other respiratory infections. In different parts of the world, the quantity of research center affirmed cases and related passings are rising consistently. The COVID- 19 is an arising pandemic-responsible viral infection. Coronavirus has influenced huge parts of the total populace, which has prompted a global general wellbeing crisis, setting all health associations on high attentive. This review sums up the overall landmass, virology, pathogenesis, the study of disease transmission, clinical introduction, determination, treatment, and control of COVID-19 with the reference to India.

scholarly journals Social contacts and other risk factors for respiratory infections among internally displaced people in Somaliland

2021 ◽  
Author(s):  
Kevin van Zandvoort ◽  
Mohamed Omer Bobe ◽  
Abdirahman Ibrahim Hassan ◽  
Mohamed Ismail Abdi ◽  
Mohamed Saed Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Infections ◽  
Severe Disease ◽  
Social Contact ◽  
Physical Contact ◽  
Cross Sectional ◽  
Internally Displaced ◽  
Internally Displaced People ◽  
Social Mixing ◽  
Displaced People

Background Populations affected by humanitarian crises experience high burdens of acute respiratory infections (ARI), potentially driven by risk factors for severe disease such as poor nutrition and underlying conditions, and risk factors that may increase transmission such as overcrowding and the possibility of high social mixing. However, little is known about social mixing patterns in these populations. Methods We conducted a cross-sectional social contact survey among internally displaced people (IDP) living in Digaale, a permanent IDP camp in Somaliland. We included questions on household demographics, shelter quality, crowding, travel frequency, health status, and recent diagnosis of pneumonia, and assessed anthropometric status in children. We calculated age-standardised social contact matrices to assess population mixing, and conducted regression analysis on risk factors for recent self-reported pneumonia. Results We found crowded households with high proportions of recent self-reported pneumonia (46% in children). 20% of children younger than five are stunted, and crude death rates are high in all age groups. ARI risk factors are common, but we did not find any significant associations with self-reported pneumonia. Participants reported around 10 direct contacts per day. Social contact patterns are assortative by age, and physical contact rates are very high (78%). Conclusions ARI risk factors are very common in this population, while the large degree of contacts that involve physical touch could further increase transmission. Such IDP settings potentially present a perfect storm of risk factors for ARIs and their transmission, and innovative approaches to address such risks are urgently needed.

scholarly journals Morbidity pattern of Kerala flood victims of 2018 in the post flood recovery phase

2019 ◽  
Vol 6 (11) ◽  
pp. 4940
Author(s):  
Saravanan Vaithiyalingam ◽  
Reenaa Mohan ◽  
Abel Arul Joseph ◽  
Mithun George Jacobe ◽  
Anil J. Purty
Keyword(s):  
Health Care ◽  
Heavy Rainfall ◽  
Respiratory Infections ◽  
Recovery Phase ◽  
Health Care Facilities ◽  
Acute Respiratory Infections ◽  
Medical Team ◽  
Skin Infections ◽  
Care Facilities ◽  
Control And Prevention

Background: In the year 2018, Kerala experienced natural disastrous due to heavy rainfall and floods due to breakdown of dams. More than five lakhs people were affected and disruption in transportation, communication and damaged health care facilities. Objective of this study was to access the morbidity pattern of flood victims in the post flood recovery phase.Methods: The study was carried out by the investigators along with medical team conducted free camps in seven different locations in the districts of Wayand and Kozhikode in the month of October 2018. Data were obtained in the format designed by the National Centers for Disease Control and Prevention, India.Results: A total of 3123 patients were attended the flood relief camp. The most of the camp people were come up with complaints of myalgia 24.8%, acute respiratory infections 14.6%, skin infections 8.3% and 7.7% had fever.Conclusions: To create awareness to the community about the natural disaster and appropriate action to prevent it through information, education and communication by regular period of intervals. And to provide basic amendments to improve the health care infra structure.

scholarly journals Post-Exposure Effects of Vaccines on Infectious Diseases

2019 ◽  
Author(s):  
Tara Gallagher ◽  
Marc Lipsitch
Keyword(s):  
Clinical Trials ◽  
Observational Studies ◽  
Case Fatality ◽  
Hepatitis E ◽  
Vaccine Preventable Diseases ◽  
Post Exposure ◽  
Vaccine Trials ◽  
Tick Borne Encephalitis ◽  
Pubmed Database ◽  
Definition Of

AbstractMany available vaccines have demonstrated post-exposure effectiveness, but no published systematic reviews have synthesized these findings. We searched the PubMed database for clinical trials and observational human studies concerning the post-exposure vaccination effects, targeting infections with an FDA-licensed vaccine plus dengue, hepatitis E, malaria, and tick borne encephalitis, which have licensed vaccines outside of the U.S. Studies concerning animal models, serologic testing, and pipeline vaccines were excluded. Eligible studies were evaluated by definition of exposure, and their attempt at distinguishing pre- and post-exposure effects was rated on a scale of 1-4. We screened 4518 articles and ultimately identified 14 clinical trials and 31 observational studies for this review, amounting to 45 eligible articles spanning 7 of the 28 vaccine-preventable diseases. For secondary attack rate, this body of evidence found the following medians for post-exposure vaccination effectiveness: hepatitis A: 85% (IQR: 28; 5 sources), hepatitis B: 85% (IQR: 22; 5 sources), measles: 83% (IQR: 21; 8 sources), varicella: 67% (IQR: 48; 9 sources), smallpox: 45% (IQR: 39; 4 sources), and mumps: 38% (IQR: 7; 2 sources). For case fatality proportions resulting from rabies and smallpox, the vaccine efficacies had medians of 100% (IQR: 0; 6 sources) and 63% (IQR: 50; 8 sources) post-exposure. Although mainly used for preventive measures, many available vaccines can modify or preclude disease if administered after exposure. This post-exposure effectiveness could be important to consider during vaccine trials and while developing new vaccines.

scholarly journals The fate of 131I-labelled diphtheria toxin and toxoid in the skin of immune and allergic guinea-pigs

1959 ◽  
Vol 57 (2) ◽  
pp. 227-234
Author(s):  
D. A. Long
Keyword(s):  
Guinea Pigs ◽  
Diphtheria Toxin ◽  
Blood Bank ◽  
University Of Pittsburgh ◽  
Diphtheria Antitoxin ◽  
The Gift ◽  
Toxin Protein ◽  
The University

Highly purified crystalline diphtheria toxin-protein, and toxoid prepared from it, were labelled with 131I, without change of potency, and injected intradermally into immune and allergic guinea-pigs. It is probable that actively immunized guinea-pigs localize these antigens and that localization is due to hypersensitivity of a type that cannot be transferred with serum; it is possibly of the delayed (tuberculin-type) of allergy.It is a pleasure to acknowledge the gift of highly purified (crystalline) diphtheria toxin, and toxoid prepared from it, from Dr C. G. Pope of the Wellcome Research Laboratories, England. Dr S. P. Masouredis of the Central Blood Bank of Pittsburgh kindly labelled these antigens, using the technique he devised. Dr W. J. Kuhns generously provided the human precipitating and non-precipitating diphtheria antitoxin*.The collimator head was made by Mr J. Nechaj of the University of Pittsburgh.All these collaborators gave me advice on matters of which I was ignorant; for this I am grateful.

scholarly journals Aortic valve endocarditis with Erysipelothrix rhusiopathiae: A rare zoonosis

2018 ◽  
Vol 10 (3) ◽  
Author(s):  
Jenny Jónsdóttir Nielsen ◽  
Bjørn Blomberg ◽  
Shahin Gaïni ◽  
Steinar Lundemoen
Keyword(s):  
Aortic Valve ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Animal Husbandry ◽  
Skin Infections ◽  
Fatality Rate ◽  
Erysipelothrix Rhusiopathiae ◽  
High Case Fatality Rate ◽  
Exposed Skin ◽  
Spare Time

Erysipelothrix rhusiopathiae has an economic impact in animal husbandry by causing infection in swine, sheep and poultry. E. rhusiopathiae is present in the surface mucoid slime on fish, although fishes do not seem to be affected. Humans can get infected, maost often through occupational exposure and may suffer typical erysipeloid infection on exposed skin such as on hands and fingers, or deeper skin infections, and sometimes sepsis and endocarditis, associated with high case-fatality rate. We describe a case of aortic valve endocarditis caused by E. rhusiopathiae in a 59-year-old man who enjoyed fishing in his spare time.

scholarly journals Seasonality, clinical types and prognostic factors of Vibrio vulnificus infection

2013 ◽  
Vol 7 (07) ◽  
pp. 533-540 ◽  
Author(s):  
Chien-Han Tsao ◽  
Chun-Chieh Chen ◽  
Shih-Jei Tsai ◽  
Chi-Rong Li ◽  
Wai-Nang Chao ◽  
...  
Keyword(s):  
Necrotizing Fasciitis ◽  
Case Fatality Rate ◽  
Vibrio Vulnificus ◽  
Case Fatality ◽  
Skin Lesions ◽  
Wound Infections ◽  
Fatality Rate ◽  
Group 2 ◽  
Vulnificus Infection ◽  
Group 1

Introduction: Vibrio vulnificus infection, an uncommon but life-threatening illness, manifests as two main types, primary septicemia and primary wound infections.  Little information regarding the seasonality of V. vulnificus infections in tropical areas and prognostic factors of primary V. vulnificus wound infections is available. Methodology: This retrospective study was conducted to include 159 V. vulnificus-infected admissions at our institution in southern Taiwan, 63 with primary septicemia (Group 1) and 96 with primary wound infections (Group 2), from 1999 to 2008, for analysis. Results: The case-fatality rate was 24%. Eighty-eight percent of these cases occurred during April to November. During December to March, patients in Group 2 were less likely to have acquired the infection compared with those in Group 1. Group 1 was more likely to have comorbidities and a higher case-fatality rate compared to Group 2. In multivariate analysis, hemorrhagic bullous skin lesions/necrotizing fasciitis (P=0.024), lesions involving two or more limbs (P=0.043), and shock on admission (P=0.015) were related to an increased mortality risk, while surgery < 24 hours after admission (P=0.001) was related to a decreased mortality risk in Group 1; however, hemorrhagic bullous skin lesions/necrotizing fasciitis (P=0.045) was the only prognostic factor in Group 2. Conclusion: The presence of hemorrhagic bullous lesion/necrotizing fasciitis is the main prognostic factor for primary septicemia or primary wound infections caused by V. vulnificus. Persons with an underlying immunocompromised status should avoid consuming raw/undercooked seafood or exposing wounds to seawater and should wear clothing during handling of seafood/fishing, especially in warmer months.

scholarly journals Assessing the Genetic Diversity of Austrian Corynebacterium diphtheriae Clinical Isolates, 2011-2019

2020 ◽  
Author(s):  
Justine Schaeffer ◽  
Steliana Huhulescu ◽  
Anna Stoeger ◽  
Franz Allerberger ◽  
Werner Ruppitsch
Keyword(s):  
Genetic Diversity ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Resistance Genes ◽  
Diphtheria Toxin ◽  
Corynebacterium Diphtheriae ◽  
Toxin Gene ◽  
Whole Genome ◽  
Skin Infections ◽  
Antimicrobial Resistance Genes

Background: Diphtheria is a vaccine preventable disease with a high potential for re-emergence. One of its causative agent is Corynebacterium diphtheriae, some strains producing the diphtheria toxin. From 2011 to 2019, 57 clinical C. diphtheriae strains were isolated in Austria, either from the respiratory track or from skin infections. Objectives: The aim of the study was to investigate the genetic diversity of these C. diphtheriae isolates using whole genome sequencing. Methods: Isolates were characterized by genome wide comparison using single nucleotide polymorphism or core genome multilocus sequence typing, and by searching sequence data for antimicrobial resistance genes and genes involved in diphtheria toxin production. Results: Genetic diversity between the isolates was high, with no clear distribution over time or place. C. belfantii isolates were separated from other strains, and were strongly associated with respiratory infections (OR = 57). Two clusters, limited in time and space, were identified. Almost 40% of strains carried resistance genes against tetracycline or sulfonamides, mostly from skin infections. Microbiological tests showed that 55% of isolates were resistant to penicillin, but did not carry genes conferring β-lactam resistance. Diphtheria toxin gene with no non-synonymous mutation was found in three isolates only. Conclusion: This study showed that sequencing can provide valuable information complementing routine microbiological and epidemiological investigations. It allowed us to identify unknown clusters, evaluate antimicrobial resistances more broadly and support toxigenicity results obtained by PCR. For these reasons, C. diphtheriae surveillance could strongly benefit from the routine implementation of whole genome sequencing.

scholarly journals Diphtheria outbreak with high mortality in northeastern Nigeria

2013 ◽  
Vol 142 (4) ◽  
pp. 797-802 ◽  
Author(s):  
N. C. BESA ◽  
M. E. COLDIRON ◽  
A. BAKRI ◽  
A. RAJI ◽  
M. J. NSUAMI ◽  
...  
Keyword(s):  
High Mortality ◽  
Clinical Characteristics ◽  
Case Fatality ◽  
Case Definition ◽  
Outbreak Investigation ◽  
Case Fatality Ratio ◽  
Diphtheria Antitoxin ◽  
Definition Of ◽  
The Village

SUMMARYA diphtheria outbreak occurred from February to November 2011 in the village of Kimba and its surrounding settlements, in Borno State, northeastern Nigeria. We conducted a retrospective outbreak investigation in Kimba village and the surrounding settlements to better describe the extent and clinical characteristics of this outbreak. Ninety-eight cases met the criteria of the case definition of diphtheria, 63 (64·3%) of whom were children aged <10 years; 98% of cases had never been immunized against diphtheria. None of the 98 cases received diphtheria antitoxin, penicillin, or erythromycin during their illness. The overall case-fatality ratio was 21·4%, and was highest in children aged 0–4 years (42·9%). Low rates of immunization, delayed clinical recognition of diphtheria and absence of treatment with antitoxin and appropriate antibiotics contributed to this epidemic and its severity.

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