[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]
Eurosurveillance, Volume 21, Issue 48, 01 December 2016 / Surveillance and outbreak report
More than 20 years after re-emerging in the 1990s, diphtheria remains a public health problem in Latvia
I Kantsone 1 2 , I Lucenko 2 , J Perevoscikovs 3
Author affiliations: 1. European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden; 2. Infectious Diseases Surveillance and Immunisation Unit, Infectious Disease Risk Analysis and Prevention Department, Centre for Disease Prevention and Control, Riga, Latvia; 3. Infectious Disease Risk Analysis and Prevention Department, Centre for Disease Prevention and Control, Riga, Latvia
Correspondence: Ieva Kantsone (email@example.com)
Citation style for this article: Kantsone I, Lucenko I, Perevoscikovs J. More than 20 years after re-emerging in the 1990s, diphtheria remains a public health problem in Latvia. Euro Surveill. 2016;21(48):pii=30414. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.48.30414
Received:30 October 2015; Accepted:20 May 2016
In 1994, the World Health Organization (WHO) declared the goal of eliminating diphtheria within the WHO European Region by the year 2000. However, in 1990 an epidemic emerged within the Russian Federation and spread to other countries, including Latvia, by 1994. We describe national surveillance and immunisation coverage data in Latvia from 1994 to 2014 and present historical data from 1946. We defined a laboratory-confirmed case as a clinical case in which toxin-producing Corynebacterium diphtheriae, C. ulcerans or C. pseudotuberculosis was isolated. From 1994 to 2014, 1,515 cases were reported, giving an average annual incidence of 3.2 cases per 100,000 inhabitants (range 0.1–14.8), with the highest incidence in age groups 5–19 and 40–49 years (4.4 and 4.3/100,000, respectively); 111 deaths were reported, 83.8% cases were laboratory-confirmed. Most cases occurred in unvaccinated adults. To improve disease control a supplementary immunisation campaign for adults was initiated in 1995, and by the end of 1998 national coverage among adults reached 70%, and reached 77% in 2003, but declined to 59% by 2014. Diphtheria remains a problem in Latvia with continued circulation of toxin-producing strains of C. diphtheriae. We recommend to strengthen immunisation to cover adults, as well as the education of health professionals and a serological survey.
Keywords: Diphtheria; Latvia.