NHS issues antibiotic-resistant diphtheria warning after cases found in Europe

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NHS laboratories have been advised to be on the lookout for antibiotic-resistant diphtheria strains after cases were discovered in Europe.

In a briefing to NHS laboratories, UK Health Security Agency said there was “concern” over research pointing to a small number of antibiotic-resistant strains of diphtheria in Europe.

The note said: “Whilst, to date, only one case in the UK has been identified as having a similar drug resistance profile, whole genome sequencing and further antibiotic sensitivity data will be systematically collected to investigate this further.”

It added: “Due to the emergence of potential antibiotic resistance, it is important that clearance of confirmed cases is monitored.”

Diphtheria is a highly contagious infection that affects the nose, throat and sometimes causes ulcers on the skin.

On Monday the European Centre for Disease Prevention and Control (ECDC) published a warning over antibiotic-resistant cases of diphtheria found in Switzerland and Germany and warned the occurrence of similar strains cannot be ruled out for other European countries.

The ECDC has also recommended as a precautionary measure that antimicrobial susceptibility testing be performed on all diphtheria samples

It comes as the inquest into the death of a man, who had diphtheria and had been held in Manston processing centre for a week, opened on Monday.

The Independent revealed last week the government failed to act on a warning in October that asylum seekers in reception centres should be vaccinated against diphtheria.

A risk assessment issued by the ECDC on 6 October said the illness was spreading among migrants and a “severe outcome” was possible for those living in crowded facilities.

At least 57 cases of diphtheria in asylum seekers have been confirmed by UKHSA up to 28 November, with one suspected death.

Some 44 of the cases have been recorded in the southeast, as well as fewer than five in each of the following areas: London; West Midlands, southwest, northeast and the northwest, the latest report said

The briefing note to laboratory staff at UKHSA on 30 November said: “Cases continue to be identified at both initial reception settings and also in hotel accommodation throughout the [asymulm seeker] pathway.

“Although most cases have been generally mild in presentation (including 25 cutaneous cases), 3 severe respiratory cases have been identified. This includes two classical respiratory diphtheria cases requiring diphtheria anti-toxin (DAT) and one fatality without culture confirmation but a throat swab was PCR positive for the toxin gene (final cause of death pending).”

It said no cases have been confirmed in staff at the processing centres or other accommodation settings.

In response to the high rates of the virus among people within people arriving at Manston and other centres in Kent, UKHSA is advising the mass prescription of preventative antibiotics and vaccinations.

It is also advising antibiotics for people who arrived after 31 October and those who were subsequently sent to hotel accommodation.

UKHSA added: “It was advised that priority within these groups being given to children under 5 years, families with children under 12 years, and those arriving from Afghanistan and Syria where diphtheria is particularly prevalent and recent health infrastructure has been disrupted.”