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Transmission of toxigenic Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West Africa, United Kingdom, 2017

In early 2017, a United Kingdom (UK)-born person in their 20s presented with a skin ulcer on the foot 3 weeks after returning from Ghana. The patient had last received a diphtheria-containing vaccine in 2013, completing the recommended course. MALDI-TOF of a cutaneous swab identified Corynebacterium...

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Autores principales: Edwards, David, Kent, Dianne, Lester, Caroline, Brown, Colin Stewart, Murphy, Michael E., Brown, Nicholas M., Sule, Olajumoke, Itani, Alexandra, Chand, Meera, Trindall, Amy, Pearson, Callum, Roddick, Iain, Fry, Norman K., Hoffmann, Jorg, Iyanger, Nalini, Kemp, Laurence, White, Joanne, Javid, Babak, Ramsay, Isobel D., Zenner, Dominik, Ahmed, Aliko, Amirthalingam, Gayatri, Salimee, Sultan, Litt, David, Reacher, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Centre for Disease Prevention and Control (ECDC) 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6169202/
https://www.ncbi.nlm.nih.gov/pubmed/30280689
http://dx.doi.org/10.2807/1560-7917.ES.2018.23.39.1700681
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author Edwards, David
Kent, Dianne
Lester, Caroline
Brown, Colin Stewart
Murphy, Michael E.
Brown, Nicholas M.
Sule, Olajumoke
Itani, Alexandra
Chand, Meera
Trindall, Amy
Pearson, Callum
Roddick, Iain
Fry, Norman K.
Hoffmann, Jorg
Iyanger, Nalini
Kemp, Laurence
White, Joanne
Javid, Babak
Ramsay, Isobel D.
Zenner, Dominik
Ahmed, Aliko
Amirthalingam, Gayatri
Salimee, Sultan
Litt, David
Reacher, Mark
author_facet Edwards, David
Kent, Dianne
Lester, Caroline
Brown, Colin Stewart
Murphy, Michael E.
Brown, Nicholas M.
Sule, Olajumoke
Itani, Alexandra
Chand, Meera
Trindall, Amy
Pearson, Callum
Roddick, Iain
Fry, Norman K.
Hoffmann, Jorg
Iyanger, Nalini
Kemp, Laurence
White, Joanne
Javid, Babak
Ramsay, Isobel D.
Zenner, Dominik
Ahmed, Aliko
Amirthalingam, Gayatri
Salimee, Sultan
Litt, David
Reacher, Mark
author_sort Edwards, David
collection PubMed
description In early 2017, a United Kingdom (UK)-born person in their 20s presented with a skin ulcer on the foot 3 weeks after returning from Ghana. The patient had last received a diphtheria-containing vaccine in 2013, completing the recommended course. MALDI-TOF of a cutaneous swab identified Corynebacterium diphtheriae. Real-time PCR ascertained the species and presence of the diphtheria toxin gene. An Elek test confirmed toxigenicity. The isolate was macrolide sensitive and penicillin resistant. The local Public Health England (PHE) Health Protection Team obtained the patient’s clinical history and traced contacts to inform appropriate public health action. One close contact (in their early 80s with uncertain immunisation status who had not recently travelled) had a positive throat swab for toxigenic C. diphtheriae and reported a history of mild coryzal symptoms. Multilocus sequence typing revealed that strains from the index case and contact had Sequence Type 463. Diphtheria is extremely rare in the UK due to high vaccine coverage and this is the first documented transmission in 30 years. Clinicians and laboratory staff should remain highly suspicious of lesions in overseas travellers, even when patients are fully vaccinated. Older individuals who might not have completed a full immunisation course may have higher diphtheria susceptibility.
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spelling pubmed-61692022018-10-12 Transmission of toxigenic Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West Africa, United Kingdom, 2017 Edwards, David Kent, Dianne Lester, Caroline Brown, Colin Stewart Murphy, Michael E. Brown, Nicholas M. Sule, Olajumoke Itani, Alexandra Chand, Meera Trindall, Amy Pearson, Callum Roddick, Iain Fry, Norman K. Hoffmann, Jorg Iyanger, Nalini Kemp, Laurence White, Joanne Javid, Babak Ramsay, Isobel D. Zenner, Dominik Ahmed, Aliko Amirthalingam, Gayatri Salimee, Sultan Litt, David Reacher, Mark Euro Surveill Surveillance and Outbreak Report In early 2017, a United Kingdom (UK)-born person in their 20s presented with a skin ulcer on the foot 3 weeks after returning from Ghana. The patient had last received a diphtheria-containing vaccine in 2013, completing the recommended course. MALDI-TOF of a cutaneous swab identified Corynebacterium diphtheriae. Real-time PCR ascertained the species and presence of the diphtheria toxin gene. An Elek test confirmed toxigenicity. The isolate was macrolide sensitive and penicillin resistant. The local Public Health England (PHE) Health Protection Team obtained the patient’s clinical history and traced contacts to inform appropriate public health action. One close contact (in their early 80s with uncertain immunisation status who had not recently travelled) had a positive throat swab for toxigenic C. diphtheriae and reported a history of mild coryzal symptoms. Multilocus sequence typing revealed that strains from the index case and contact had Sequence Type 463. Diphtheria is extremely rare in the UK due to high vaccine coverage and this is the first documented transmission in 30 years. Clinicians and laboratory staff should remain highly suspicious of lesions in overseas travellers, even when patients are fully vaccinated. Older individuals who might not have completed a full immunisation course may have higher diphtheria susceptibility. European Centre for Disease Prevention and Control (ECDC) 2018-09-27 /pmc/articles/PMC6169202/ /pubmed/30280689 http://dx.doi.org/10.2807/1560-7917.ES.2018.23.39.1700681 Text en This article is copyright of The Authors, 2018. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.
spellingShingle Surveillance and Outbreak Report
Edwards, David
Kent, Dianne
Lester, Caroline
Brown, Colin Stewart
Murphy, Michael E.
Brown, Nicholas M.
Sule, Olajumoke
Itani, Alexandra
Chand, Meera
Trindall, Amy
Pearson, Callum
Roddick, Iain
Fry, Norman K.
Hoffmann, Jorg
Iyanger, Nalini
Kemp, Laurence
White, Joanne
Javid, Babak
Ramsay, Isobel D.
Zenner, Dominik
Ahmed, Aliko
Amirthalingam, Gayatri
Salimee, Sultan
Litt, David
Reacher, Mark
Transmission of toxigenic Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West Africa, United Kingdom, 2017
title Transmission of toxigenic Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West Africa, United Kingdom, 2017
title_full Transmission of toxigenic Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West Africa, United Kingdom, 2017
title_fullStr Transmission of toxigenic Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West Africa, United Kingdom, 2017
title_full_unstemmed Transmission of toxigenic Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West Africa, United Kingdom, 2017
title_short Transmission of toxigenic Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West Africa, United Kingdom, 2017
title_sort transmission of toxigenic corynebacterium diphtheriae by a fully immunised resident returning from a visit to west africa, united kingdom, 2017
topic Surveillance and Outbreak Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6169202/
https://www.ncbi.nlm.nih.gov/pubmed/30280689
http://dx.doi.org/10.2807/1560-7917.ES.2018.23.39.1700681
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