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Epidemiological Update - Diphtheria - 29 October 2018

Situation Report
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Diphtheria in the Americas - Summary of the situation

Between epidemiological week (EW) 1 and EW 41 of 2018, three countries in the Region of the Americas (Colombia, Haiti, and the Bolivarian Republic of Venezuela) have reported confirmed cases of diphtheria. In Haiti and Venezuela, the outbreaks are ongoing.

The following is a summary of the epidemiological situation in these countries.

In Colombia, 8 confirmed cases, including 3 deaths have been reported. Since July 2018, there have been no additional cases of diphtheria reported.

In Haiti, the outbreak is ongoing with a cumulative total of 712 probable cases1, including 105 deaths, reported between EW 51 of 2014 and EW 41 of 2018 (Figure 1). Of the total cases, 249 cases were confirmed (242 by laboratory and 7 by epidemiological link). The number of probable cases reported in 2018 is higher than the total number of cases reported in 2017 and 2016 due to increased sensitivity of the national surveillance system.

The case-fatality rate among laboratory-confirmed cases was 23% in 2015, 37% in 2016, 8% in 2017, and 9% in 2018.

Between EW 1 and EW 41 of 2018, 319 probable cases were reported, including 80 confirmed cases (75 by laboratory and 5 by epidemiological link). During the same period, there were 25 deaths reported (12 laboratory-confirmed or by epidemiological link, 8 with no viable laboratory samples, 4 under investigation, and one that was discarded).

Among confirmed cases in 2018 (n=80), ages range from 2 to 33 years, 91% are less than 15 years old, and 49% are female.

In Venezuela, the diphtheria outbreak that began in July 2016 remains ongoing (Figure 2).
Since the beginning of the outbreak until EW 41 of 2018, a total of 2,170 suspected cases were reported (324 cases in 2016, 1,040 in 2017, and 800 in 2018); of these, 1,249 were confirmed. A total of 287 deaths were reported (17 in 2016, 103 in 2017, and 167 in 2018).
The cumulative case-fatality rate among confirmed cases is 23%.