Corynebacterium. Credit score: Institut Pasteur
A examine revealed within the New England Journal of Medication reveals that the biggest diphtheria epidemic in Western Europe for 70 years, which broke out in 2022 amongst migrants and in 2023 unfold to different susceptible populations in a number of European nations, is the results of contaminations occurring throughout migratory journey or in vacation spot European nations, and never within the nations of origin.
Nevertheless, the geographical space and situations of those preliminary contaminations are nonetheless unknown. A genetic hyperlink has additionally been established between the pressure that circulated throughout the 2022 epidemic and an epidemic that occurred in Germany in 2025, suggesting that the bacterium has been circulating silently in Western Europe.
Whereas demonstrating the effectiveness of vaccination applications for the final inhabitants, this analysis, carried out by a global staff together with researchers from the Institut Pasteur and epidemiologists from Santé publique France, underlines the significance of sustaining a excessive stage of vigilance and public well being assist devoted to diphtheria (vaccination, screening, scientific examination) amongst susceptible populations in Western Europe.
In 2022, a number of European nations noticed an uncommon spike in instances of an infection with the bacterium liable for diphtheria (Corynebacterium diphtheriae), primarily amongst migrants who had lately arrived in Europe.
A complete of 362 instances had been recorded in Europe that yr by the European Middle for Illness Prevention and Management (ECDC). By the tip of 2022, speedy intervention measures akin to contact tracing and screening of secondary instances had mitigated the epidemic. In 2023, 123 instances had been reported in Austria, France, Germany, Switzerland, the Netherlands and the UK (Rising Infectious Ailments).
Regardless of this decline, uncommon infections have been noticed in these nations amongst migrant populations and different susceptible populations, significantly the homeless, since 2022 and as much as the current day. A complete of 536 instances, together with not less than three deaths, have been reported in Europe because the begin of the 2022 epidemic.
A clearer epidemiological image, however the origin and scope are nonetheless unknown
The researchers analyzed 363 isolates from 362 sufferers in ten European nations. The info reveal that 98% of sufferers had been male, with a median age of 18, 96% of whom had lately migrated to Europe. Nearly all of infections (77%) had been cutaneous, with 15% of extra extreme respiratory kinds.
The examine exhibits that the epidemic, which has primarily affected migrant populations from Afghanistan and Syria, will not be the results of preliminary contamination in these nations of origin, however reasonably contamination throughout migratory journeys or in reception facilities in European nations.
Genomic evaluation of the bacterial strains circulating throughout the epidemic confirmed a really excessive diploma of genetic proximity between the strains noticed in folks from completely different nations, implying the existence of a current level of contact, outdoors the nation of origin, which led to contamination.
The almost definitely speculation is that this level of contact is a number of locations frequented by migrants on their journey from their nation of origin or within the vacation spot nations. The precise scale of the epidemic stays troublesome to find out because of the limitations inherent in screening these susceptible populations.
Vital outcomes for public well being
“This study highlights the crucial importance of cross-border epidemiological surveillance and international collaboration in epidemic response,” says Prof. Sylvain Brisse of the Institut Pasteur, one of many examine coordinators.
“The rapid sharing of sequencing data between countries has made it possible to define the common characteristics of diphtheria strains and adapt the health response.”
In view of the foremost unknowns that stick with regard to this epidemic, public well being consultants are calling for vigilance and the strengthening of public well being measures geared toward susceptible populations in Western Europe: elevating consciousness of illness signs amongst docs and, extra broadly, folks involved with the susceptible populations involved, checking (and updating if obligatory) vaccination standing, acceptable antibiotic therapies, and so on.
General, the outcomes spotlight the necessity to step up surveillance of infectious illnesses in susceptible populations, enhance entry to well being care and vaccination for migrant populations, and preserve heightened vigilance within the face of rising antibiotic resistance.
Isabelle Mum or dad du Châtelet, unit supervisor at Santé publique France, states that “the examine exhibits how vital it’s to make sure that diphtheria immunization ranges are updated, significantly for susceptible inhabitants teams, akin to migrants, and that diphtheria poses a threat particularly amongst homeless folks, injecting drug customers, unvaccinated people and aged folks with pre-existing diseases, in addition to folks with skilled ties to those teams.
“It also means that clinicians need to be aware of and pay attention to the common symptoms of diphtheria, especially when their patients have a professional or other link with these vulnerable populations.”
The examine is a part of a concerted method to diphtheria monitoring and management in Europe, led by the European Middle for Illness Prevention and Management (ECDC) and an advert hoc consortium of analysis and public well being establishments within the nations involved.
Extra info:
Corynebacterium diphtheriae outbreak amongst migrant populations in Europe, New England Journal of Medication (2025).
Offered by
Pasteur Institute
Quotation:
Current diphtheria epidemic in Western Europe traced to migration routes, not nations of origin (2025, June 4)
retrieved 4 June 2025
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