ECDC survey shows gaps in diphtheria diagnostic capacity across Europe

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This ECDC gap analysis demonstrates that there are potentially significant gaps in diphtheria diagnostic capacity within the EU/EEA in terms of surveillance, specialised laboratory diagnostics, expertise and availability of diphtheria antitoxin (DAT). The results highlight the importance of sound surveillance systems for diphtheria and laboratory personnel training, as well as the need to ensure access to immunisation and high vaccination coverage rates.

This gap analysis collected information from across all EU/EEA Member States about laboratory capacity related to diphtheria control, following the fatal cases reported in Europe in 2015 and 2016.

Diphtheria is a vaccine-preventable transmissible acute infection mainly affecting the upper respiratory tract. Clinical diphtheria is caused by toxin-producing corynebacteria. Infections can be difficult to diagnose on clinical grounds, and it is essential that clinicians are equipped with the knowledge required to promptly recognise and treat diphtheria.

The ECDC survey results show significant gaps in core areas of capacity related to diphtheria control, such as surveillance for all three diphtheria pathogens, diagnostic capability to detect toxigenicity, and laboratory personnel expertise and training.

The availability of diphtheria antitoxin (DAT) is another key issue: less than half of the responding Member States have a DAT stockpile for treatment, and 18 countries reported problems in obtaining DAT supplies for laboratory diagnostics. DAT is listed among the WHO Essential Medicines, and successful treatment of diphtheria depends on its rapid administration even upon suspicion of a case, in combination with antibiotics.

Universal vaccination remains the single most effective preventive control measure for diphtheria”,

states ECDC Director Andrea Ammon. Thus, vaccination against diphtheria in children, adolescents and adults should follow the national immunisation schedules.

Although this report highlights gaps in diagnostic capacity, laboratory resources and diphtheria antitoxin supplies in Europe, the diphtheria vaccine is available in all EU/EEA Member States. We need to ensure immunisation rates remain high

The ECDC is currently working to provide technical and scientific support to help Member States address the most critical gaps identified in the report. The ECDC is also fostering dialogue across stakeholders to assess how to improve DAT availability in Europe. At the same time, work is in progress to address growing concerns on vaccine hesitancy, in order to keep immunisation rates above the minimum 95% level recommended.

More information

Gap analysis on securing diphtheria diagnostic capacity and diphtheria antitoxin availability in the EU/EEA

This gap analysis demonstrated that there are significant gaps in diphtheria diagnostic capacity within the EU/EEA, with only six Member States fulfilling the minimum criteria in terms of surveillance, specialised laboratory diagnostics and expertise.

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Diphtheria is an acute disease caused by toxin-producing strains of Corynebacterium diphtheriae (in some cases also by Corynebacterium ulcerans) bacteria, that is known to colonise mucous membranes.

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