An Investigation of Diphtheria in Khowang District, Yasothon Province, Thailand, August– September 2013

Abstract

Background: There was a re-emerging of diphtheria in 2013 at Yasothon province where had been disease free for 17 years. We conducted outbreak investigation during 30th August - 27th September, 2013 with aimed to confirm a diagnosis and outbreak, to describe the magnitude of the problem and to implement control measures
Methods: Descriptive epidemiological study was done. The laboratory testing to determine the C. diphtheriae among cases and closed contact was carried out. The environmental surveys at a patient’s home, community and schools also were conducted. Active case finding and identifying close contacts was implemented. We reviewed medical records and interviewed the case by standard questionnaires.
Results: We found 1 probable case of 4-years old boy with lab confirmation of non toxin-produced Corynebacterium diphtheriae. Two carriers were identified with lab confirmation of toxin-produced Corynebacterium diphtheriae. Their ages were 4 years and 27 years. The probable cases and 1 carrier were peers who live in the same village. Of those 3 carriers, only one received full course of immunization as recommended in the Expanded Program on Immunization. The remaining 1 carrier was close contacts of the carriers in the community and they had not completely received vaccines. Rapid survey of vaccine coverage among 123 children in the outbreak area revealed completely received vaccines by schedule.
Conclusion and discussions: The key success control measures were health educations provided to school teachers, students, village and guardians together with administering DPT/dT vaccines for 1,346 people within 2 weeks after detection of the index case. The outbreak was contained and no additional case after implement control in the affected area.