A1 Refereed original research article in a scientific journal

Epidemiology of three cases of severe diphtheria in Finnish patients with low antitoxin antibody levels




AuthorsLumio J, Olander RM, Groundstroem K, Suomalainen P, Honkanen T, Vuopio-Varkila J

Publication year2001

JournalEuropean Journal of Clinical Microbiology and Infectious Diseases

Journal name in sourceEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology

Journal acronymEur J Clin Microbiol Infect Dis

Volume20

Issue10

First page 705

Last page10

Number of pages6

ISSN0934-9723

DOIhttps://doi.org/10.1007/s100960100594


Abstract
During the 1990-1998 diphtheria epidemic in the newly independent states of the former Soviet Union, more than 150,000 infections and 5,000 deaths occurred. During this period, more than 10 million trips were made from Finland to Russia or vice versa. This resulted in only 10 cases of diphtheria in Finland. There was no secondary spread to healthcare workers or other close contacts. Three patients had severe respiratory tract diphtheria. All three were middle-aged men who had made a short visit to Russia, during which time they had intimate contact with local women. These findings suggest diphtheria was transmitted mainly by direct saliva contact. All patients with severe diphtheria had a non-protective level of antitoxin antibodies during the first days of the disease. Only the patient whose antibody titre rose rapidly to a protective level (>1 IU/ml) had an uncomplicated recovery. The other two, one of whom died, had myocarditis and severe polyneuropathy.



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