Diphtheria Outbreak in Bait Hulboob, Wasman Villages, Ibb governorate - Yemen, September 2017

Abstract

Background: Remerging of diphtheria outbreaks have been associated with wars and threaten the health of children and adult. On 25th of September 2017 surveillance officer of Ibb governorate received a notification from surveillance coordinator of Alsaddah district about suspected deaths due to diphtheria. A team from Ibb surveillance office was sent to investigate on 26/09/2017.

Objective: To verify the existence of an outbreak, describe its epidemiology and recommend preventive and control measures.

Methods: A descriptive study was done. WHO case definition was used. A line list was created, active case finding, and clinical diagnosis were performed. Records of surveillance and vaccinations programs were reviewed. Data was entered and analyzed using Excel program. Descriptive statistics were performed.

Results: A total of 63 cases were identified. The first case was in Epi week 34, the highest peak with 32 cases were in week 38. The index case was 17 years old male from Bait Hulboob village. The majority of cases 47 (74%), were from that village. Almost three quarters of cases 45 (71%) were males, 22 cases (35%) among children aged from 5-10years. 43 cases (68%) was unvaccinated and the rest was partially vaccinated. All presented with pseudo membrane, 42 cases (67%) with sore throat and 10 (16%) with bull neck. The attack rate was 15/1000. 4 cases died (the case fatality rate was 6%).

Conclusions: Diphtheria outbreak was clinically confirmed. Low vaccination coverage. Vaccination campaign for population and provision of Diphtheria antitoxin for patients are urgently recommended. Immunization and health education should be emphasized by governorate authority.