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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">IPROC</journal-id>
      <journal-id journal-id-type="nlm-ta">iproc</journal-id>
      <journal-title>Iproceedings</journal-title>
      <issn pub-type="epub">2369-6893</issn>
      <publisher>
        <publisher-name>JMIR Publications</publisher-name>
        <publisher-loc>Toronto, Canada</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
    <article-id pub-id-type="publisher-id">v4i1e10589</article-id>
    <article-id pub-id-type="pmid"/>
    <article-id pub-id-type="doi">10.2196/10589</article-id>
    <article-categories>
      <subj-group subj-group-type="heading">
        <subject> Abstract </subject>
      </subj-group>
      <subj-group subj-group-type="article-type">
        <subject> Abstract </subject>
      </subj-group>
    </article-categories>
    <title-group>
      <article-title>Diphtheria Outbreak in Bait Hulboob, Wasman Villages, Ibb governorate - Yemen, September 2017</article-title>
    </title-group>
    <contrib-group>
      <contrib contrib-type="editor">
        <name>
          <surname>Khader</surname>
          <given-names>Yousef</given-names>
        </name>
      </contrib>
    </contrib-group>
    <contrib-group>
      <contrib contrib-type="author" id="contrib1" corresp="yes">
        <name name-style="western">
          <surname>Alhasani</surname>
          <given-names>Ali</given-names>
        </name>
      </contrib>
    </contrib-group>
    <author-notes>
      <corresp>Corresponding Author: Ali Alhasani 
      <email>ailalhassni@hotmail.com</email></corresp>
    </author-notes>
    <pub-date pub-type="collection"><season>Jan-Dec</season><year>2018</year></pub-date>
    <pub-date pub-type="epub">
      <day>29</day>
      <month>03</month>
      <year>2018</year>
    </pub-date>
    <volume>4</volume>
    <issue>1</issue>
    <elocation-id>e10589</elocation-id>
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    <history>
      <date date-type="received">
        <day>29</day>
        <month>3</month>
        <year>2018</year>
      </date>
      <date date-type="accepted">
        <day>29</day>
        <month>3</month>
        <year>2018</year>
      </date>
    </history>
    <!--(c) the authors - correct author names and publication date here if necessary. Date in form ', dd.mm.yyyy' after jmir.org-->
    <copyright-statement>©Ali Alhasani. Originally published in Iproceedings (http://www.iproc.org), 29.03.2018.</copyright-statement>
    <copyright-year>2018</copyright-year>
    <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
      <p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on http://www.iproc.org/, as well as this copyright and license information must be included.</p>
    </license>  
    <self-uri xlink:href="http://www.iproc.org/2018/1/e10589/" xlink:type="simple"/>
    <abstract>
      <sec sec-type="background">
        <title>Background</title>
        <p>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.</p>
      </sec>
      <sec sec-type="objective">
        <title>Objective</title>
        <p>To verify the existence of an outbreak, describe its epidemiology and recommend preventive and control measures.</p>
      </sec>
      <sec sec-type="methods">
        <title>Methods</title>
        <p>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.</p>
      </sec>
      <sec sec-type="results">
        <title>Results</title>
        <p>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%).</p>
      </sec>
      <sec sec-type="conclusions">
        <title>Conclusions</title>
        <p>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.</p>
      </sec>
    </abstract></article-meta>
  </front>

</article>
