Diphtheria in a Swiss Asylum Seeker Reception Centre

TY - JOUR

T1 - Diphtheria in a Swiss Asylum Seeker Reception Centre

T2 - Outbreak Investigation and Evaluation of Testing and Vaccination Strategies

AU - Brockhaus, Lisa

AU - Urwyler, Pascal

AU - Leutwyler, Ulrike

AU - Würfel, Eva

AU - Kohns Vasconcelos, Malte

AU - Goldenberger, Daniel

AU - Keller, Peter Michael

AU - Tschudin Sutter, Sarah

AU - Labhardt, Niklaus Daniel

N1 - Copyright © 2024 Brockhaus, Urwyler, Leutwyler, Würfel, Kohns Vasconcelos, Goldenberger, Keller, Tschudin Sutter and Labhardt.

PY - 2024/4/24

Y1 - 2024/4/24

N2 - Objectives: To describe a suspected diphtheria outbreak in a Swiss asylum seeker reception centre, and to analyse its management response regarding testing and vaccination. Methods: We retrospectively analysed clinical, microbiology, and case management data of all asylum seekers tested for C. diphtheriae between 28th August and 31st December 2022 while residing at the centre. Results are reported descriptively. Results: Among 265 individuals tested, ten cases of cutaneous diphtheria, one simultaneous respiratory and cutaneous case, and nine respiratory carriers were identified. Mass throat screening, targeted throat testing and targeted wound testing yielded 4.8%, 4.3%, and 17.4% positive results, respectively. No respiratory carrier was identified among cutaneous cases undergoing a throat swab, and no symptomatic case was identified among individuals with unspecific throat symptoms. Rates of vaccination implementation of newly arriving asylum seekers before and after the outbreak were low (17.5% and 15.5%, respectively), as were rates of targeted vaccination among cases and close contacts. Conclusion: We provide evidence for transmission both prior to arrival and within the setting, suboptimal practices and timeliness of testing, and implementation gaps in vaccination.

AB - Objectives: To describe a suspected diphtheria outbreak in a Swiss asylum seeker reception centre, and to analyse its management response regarding testing and vaccination. Methods: We retrospectively analysed clinical, microbiology, and case management data of all asylum seekers tested for C. diphtheriae between 28th August and 31st December 2022 while residing at the centre. Results are reported descriptively. Results: Among 265 individuals tested, ten cases of cutaneous diphtheria, one simultaneous respiratory and cutaneous case, and nine respiratory carriers were identified. Mass throat screening, targeted throat testing and targeted wound testing yielded 4.8%, 4.3%, and 17.4% positive results, respectively. No respiratory carrier was identified among cutaneous cases undergoing a throat swab, and no symptomatic case was identified among individuals with unspecific throat symptoms. Rates of vaccination implementation of newly arriving asylum seekers before and after the outbreak were low (17.5% and 15.5%, respectively), as were rates of targeted vaccination among cases and close contacts. Conclusion: We provide evidence for transmission both prior to arrival and within the setting, suboptimal practices and timeliness of testing, and implementation gaps in vaccination.

KW - Humans

KW - Switzerland

KW - Refugees/statistics & numerical data

KW - Diphtheria/prevention & control

KW - Disease Outbreaks/prevention & control

KW - Retrospective Studies

KW - Male

KW - Female

KW - Adult

KW - Adolescent

KW - Young Adult

KW - Vaccination/statistics & numerical data

KW - Corynebacterium diphtheriae

KW - Middle Aged

KW - Mass Screening

U2 - 10.3389/ijph.2024.1606791

DO - 10.3389/ijph.2024.1606791

M3 - SCORING: Journal article

C2 - 38721474

VL - 69

SP - 1606791

JO - INT J PUBLIC HEALTH

JF - INT J PUBLIC HEALTH

SN - 1661-8556

ER -