The New Zealand Ministry of Health has advised the National Centre for Disease Control of a case in Auckland in which toxigenic Corynebacterium diphtheriae was isolated from the throat of a 32 month old unimmunised child with pharyngitis. The child responded to antibiotics and did not require hospitalisation or antitoxin. This was the first isolate of toxigenic diphtheria in New Zealand since 1987. The case highlights the need to ensure that infants, children and adults are fully immunised against diphtheria.
There have been no notifications of diphtheria due to toxigenic Corynebacterium diphtheriae in Australia since 1993, when one case was reported. However, both toxigenic and non-toxigenic strains of the organism have been shown to be endemic in parts of Australia and there remains the potential for serious disease to occur.1 Children and adults who are unimmunised, or whose immunity has waned because they have not received appropriate boosting, remain at risk of contracting the disease and spreading it within the community.2,3 All children and adults should be vaccinated in accordance with the recommendations of the National Health and Medical Research Council.4 These were last published in CDI in 1997 and are reiterated below.
References1. Patel M, Morey F, Butcher A, Moore C, Brennan R and Mollison L. The frequent isolation of toxigenic and non-toxigenic toxigenic Corynebacterium diphtheriae at Alice Springs Hospital. Commun Dis Intell 1994;18:310-311.
2. Gilbert L. Infections with Corynebacterium diphtheriae - changing epidemiology and clinical manifestations. Commun Dis Intell 1997;21:161-164.
3. Kilham H and Benn R. Diphtheria - the Australian perspective (Editorial). Commun Dis Intell 1997;21:164-165.
4. National Health and Medical Research Council. The Australian Immunisation Handbook, Sixth edition. Canberra: Australian Government Publishing Service, 1997
This article was published in Communicable Diseases Intelligence Volume 22, No 9, September 1998.