Child diagnosed with diphtheria

By Gillian Slade on June 21, 2018.

gslade@medicinehatnews.com  @MHNGillianSlade

A student from Elm Street School has been diagnosed with diphtheria, an illness that is rare in Canada and, in some cases, has the potential to be fatal.

The student had not been travelling outside Canada and is not known to have been in contact with anyone else diagnosed with diphtheria.

“This is very rare and it is one of a few that we have known of in the south zone for years,” said Lizette Elumir, medical officer of health, Alberta Health Services south zone. “So for it to come up is a rare instance … and it is not something where we have to be scouring the city to find the contact.”

Without previous immunization records in Alberta, the student was in the process of getting fully immunized, said Elumir.

Diphtheria vaccine is generally combined with others such as tetanus and pertussis and given to babies at two, four, six and 18 months, followed by a booster between the ages of four and six and again in Grade 9, said Elumir. Boosters are then given every 10 years.

There were no cases of diphtheria in Alberta between 2008 and 2016. In 2017, there was one case in Edmonton and another in Calgary, said a spokesperson for AHS.

The good news is it is treatable with antibiotics and it is preventable through immunization, said Elumir.

“Thanks to immunization, in the last 20 years less than five cases of diphtheria are reported each year in Canada,” according to the federal government’s website.

That same website reports there are currently diphtheria outbreaks in Bangladesh, Haiti, Indonesia, Venezuela and Yemen.

The Elm Street School student and people living in the same household, “a small number,” are staying home currently, said Elumir. No other students at the school have had to be isolated.

“We have already contacted and managed every presumed contact and the bottom line is diphtheria is transmitted by significant contact,” said Elumir.

The child with diphtheria has not required hospitalization, said Elumir.

An AHS letter sent home with Elm Street School students on Tuesday, June 19, was dated June 8. Elumir says that date is incorrect. The diphtheria diagnosis was confirmed Friday, June 15. The letter was given to the superintendent on Monday. It should have been dated June 18, not 8, she explained.

“The general public is still at very low risk,” said Elumir.

This local diphtheria diagnosis will again raise the issue of some people choosing not to vaccinate their children for a variety of reasons, said Elumir. The vaccine is effective against diphtheria but there is waning immunity over time, and that is one reason why it is important to confirm whether you need a booster shot every 10 years.

If your immunization data is on record with the local community health office they will be able to advise whether you are due for a booster.

If you have moved here from another region or country and do not have your own official immunization records a good place to start would be with your family doctor, said Elumir.

“Please get yourself vaccinated and please stay home when you’re sick,” said Elumir.

Diphtheria symptoms include sore throat, hoarseness, difficulty swallowing, bloody nasal discharge, fever. It is spread through respiratory secretions and by direct contact with skin lesions, said Elumir. The skin lesions are very rare.

If you suspect you or your child has diphtheria, contact your family doctor promptly to make arrangements for a diagnosis. Do not go to any public place or engage in social activity until you have been assessed, advises Elumir. Practise strict respiratory etiquette by coughing or sneezing into your elbow, wash your hands frequently, and immediately throw away used tissues in the garbage.

Diphtheria symptoms usually start two to five days after exposure, according to Wikipedia. In severe cases, a white patch develops in the throat that can block the airway and the neck may swell due to enlarged lymph nodes.

There used to be about a million cases of diphtheria in the world every year, prior to the 1980s. In 2015 ,there were 4,500 cases across the world, resulting in 2,100 deaths, according to Wikipedia.

The site says it was Pierre Bretonneau who in 1826 gave the disease it’s name — diphtherite — from the Greek word diphthera, meaning leather, which describes the appearance of the pseudomembrane in the throat.

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