Suchergebnisse

The government held a diphtheria sub-national immunization week in 2012 to overcome the problem of diphtheria outbreaks in East Java Province. Bangkalan District is the district with the high incidence of diphtheria in East Java Province. This study aims to analyze the determinants of diphtheria events in Bangkalan District after the diphtheria sub-national immunization week in 2012. This study uses a case-control study design. Case samples were taken from a total of 31 cases, and control samples were taken as many as 124 people spread in 25 case villages and25 control villages. The bivariate analysis a using chi-square test and simple logistic regression. Multivariate analysis using logistic regression. The results showed that based on the results of bivariate analysis, individual and household levels related to diphtheria events, namely the status of Diphtheria Pertussis Tetanus (DPT) immunization, sub-national immunization week status, age and mother's education. Multivariate analysis showed that factors related to the diphtheria incidence in Bangkalan District after the 2012 diphtheria sub-national immunization week were DPT immunization (p = 0.012; OR= 4.765), incomplete DPT immunization (p = 0.001; OR = 6.276), age 3- 7 years (p = 0.014; OR = 15.137), ages 7-15 years (p = 0.001; OR = 41.984), and are not immunized at the time of sub-national immunization week (p = 0.020; OR = 3.553). The conclusion of this study is the DPT immunization status, age and status of diphtheria sub-national immunization week were the dominant factors affecting the incidence of diphtheria in Bangkalan District.

Background: Diphteria can be prevented by immunization of DPT-HB-Hib (Diphteria, Hepatitis B, dan Haemophillus Influenze B) to infants and DPT-HB-Hib Booster, DT (Diphteria Tetanus) and Td (Tetanus Diphteria) afterwards. In 2017, diphteria case rate in Surabaya was high, 29 cases, due to the lack of 7 dosages of diphteria immunization. Purpose: This study aimed to depict the completion history of diphteria immunization based on the completness of immunization status which suits to age groups of diphteria patients in Surabaya in 2017. Methods: This study was quantitave descriptive with study cross sectional design. The objects of this study were diphteria patients in Surabaya in 2017 (29 individuals). Data was collected by questionnaire and immunization record from KIA/KMS books which belongs to Government effort to control Citizen Health Development. The variables of this study was diphteria patients characteristics (age and gender) and the history diphteria immunization. Data were analyzed using univariate analysis with frequency table. Results: This study obtained that mostly the diphteria patients in Surabaya in 2017 suffered this disease in 18 until 84 months old (58.62%) and mostly happened to male (82.76%). All patients aged 18 months old received complete diphteria immunization (3.45%), but all patient aged more than ≥ 18 months old did not received complete diphteria immunization (96.55%). Mostly the patients did not receive re-immunization afterwards, i.e DPT-HB-Hib Booster, DT, and Td. Conclusion: The completion 7 dosages of diphteria immunization is important to diphteria cases, especially to diphteria re-immunization afterwards.

The diphtheria immunity status was determined with the passive haemagglutination technique in 503 sera of 10-90-year-old persons from Warsaw and Olsztyn Provinces. Donors of sera were students, teachers, pregnant women, employees of industry and medical service. The immunity was highest (90% of titers 0.1 IU/ml or higher) in persons below 20 years of age and in persons above 60 years of age (55%). Between these two groups, gaps in immunity exist, the proportion of those immune varying from 36-50% in the 20- 60-year-old groups. Since a large pool of susceptible persons creates an epidemic potential it was suggested that the adult type of tetanus-diphtheria toxoid (Td) should be introduced into the routine immunization schedule for high risk groups. These groups might include professional or age groups who are vulnerable to reintroduction of virulent Corynebacterium diphtheriae such as kindergarten and creches personnel, teachers, students, military service personnel and persons travelling to developing countries.

Quoique le taux de mortalité général ne cesse de décliner pour l'ensemble de la Suède, après 1810, certains groupes d'ôge ne présentent pas ce modèle de comportement. La mortalité des enfants augmente en effet – particulièrement de 1 à 10 ans – après 1850. Cet accroissement est en partie attribué à des épidémies de diphtérie. Cet article s'attache à présenter la législation en matière de santé publique en Suède à cette époque, en particulier à l'egard des maladies infectieuses, et étudie deux villes, Sundsvall et Göteborg, qui furent l'objet de sévères épidémies de diphtérie. La législation imposait que soient présentés des rapports réguliers à l'administration centrale. Néanmoins, on voit varier d'une ville à l'autre aussi bien les dispositions prises pour les hôpitaux spécialisés dans les maladies infectieuses que les mesures d'isolation des malades contagieux et les modalités de désinfection des maisons touchées par l'épidémie ou plus tard le recours à des serum traitants. En conclusion nous posons la question de savoir si l'opinion publique s'est émue de cet accroissement de la mortalité enfantine.

Corynebacterium diphtheriae is the classical etiological agent of diphtheria and the type strain of the genus Corynebacterium. While diphtheria of the respiratory tract became rare with the introduction of vaccination programs in industrialized countries, even today several thousand cases per year are reported to the World Health Organization. This shows that diphtheria is not completely eradicated and that reservoirs exist. The book summarizes the latest advances made in understanding C. diphtheriae and the closely related species Corynebacterium ulcerans and Corynebacterium pseudotuberculosis. Topics addressed are genomics of toxigenic corynebacteria, host-pathogen-interaction, detection, surveillance and treatment as well as application aspects.

The diphtheria surveillance network (DIPNET) encompassing National Diphtheria Reference Centers from 25 European countries is a Dedicated Surveillance Network recognized by the European Commission. A key DIPNET objective is the quality assessment of microbiological procedures for diphtheria across the European Union and beyond. A detailed questionnaire on the level of reference laboratory services and an external quality assessment (EQA) panel comprising six simulated throat specimens were sent to 34 centers. Twenty-three centers are designated National Diphtheria Reference Centers, with the laboratory in the United Kingdom being the only WHO Collaborating Centre. A variety of screening and identification tests were used, including the cysteinase test (20/34 centers), pyrazinamidase test (17/34 centers), and commercial kits (25/34 centers). The classic Elek test for toxigenicity testing is mostly used (28/34 centers), with variations in serum sources and antitoxin concentrations. Many laboratories reported problems obtaining Elek reagents or media. Only six centers produced acceptable results for all six specimens. Overall, 21% of identification and 13% of toxigenicity reports were unacceptable. Many centers could not isolate the target organism, and most found difficulties with the specimens that contained Corynebacterium striatum as a commensal contaminant. Nineteen centers generated either false-positive or negative toxigenic results, which may have caused inappropriate medical management. The discrepancies in this diphtheria diagnostics EQA alarmingly reflect the urgent need to improve laboratory performance in diphtheria diagnostics in Europe, standardize feasible and robust microbiological methods, and build awareness among public health authorities. Therefore, DIPNET recommends that regular workshops and EQA distributions for diphtheria diagnostics should be supported and maintained.

Despite the introduction of mass immunization, diphtheria continues to play a major role as a potentially lethal infectious disease in many countries. Delay in the specific therapy of diphtheria may result in death and, therefore, accurate diagnosis of diphtheria is imperative. This study was carried out at National Centre for Disease Control (NCDC), Delhi, India, on samples of suspected diphtheria cases referred from various government hospitals of Delhi and neighbouring areas during 2012-2014. Primary identification of Corynebacterium diphtheriae was done by standard culture, staining and biochemical tests followed by toxigenicity testing by Elek's test on samples positive for C. diphtheriae. The results showed persistence of toxigenic C. diphtheriae in our community indicating the possibility of inadequate immunization coverage.

The European Diphtheria Surveillance Network (EDSN) ensures the reliable epidemiological and microbiologic assessment of disease prevalence in the European Union. Here, we describe a survey of current diagnostic techniques for diphtheria surveillance conducted across the European Union and report the results from three external quality assessment (EQA) schemes performed between 2010 and 2014.

Summary
The evolution of professionalism in Minnesota began when allopathic and homeopathic physician leaders organised medical societies and colleges to define and perpetuate their styles of practice. The epidemics of diphtheria that ravaged the state demanded prompt public health measures of quarantine to reduce the spread of the disease. Then the successful utilization of diphtheria antitoxin in Europe encouraged its local production in Minnesota and the re-education of all physicians there to convince them that they were no longer helpless to treat this infection that killed so many children. Their professionalisation was completed when they implemented the cure for diphtheria that laboratory science had produced. Homeopathic and allopathic practices converged as Minnesota physicians transformed their occupation from merely caring and comforting to actively treating and curing a serious infection.