Infections with Corynebacterium diphtheriae - changing epidemiology and clinical manifestations: Report of the third international meeting of the European Laboratory Working Group on Diphtheria (ELWGD), Institut Pasteur, Paris 7 - 8 June 1996

Abstract

A widespread epidemic of diphtheria began in 1990 in the former Soviet Union, in the context of falling immunisation rates and social disruption. Control was impeded by limited diagnostic resources in affected countries (mainly Russia) and there was a risk of spread to neighbouring countries. The European Laboratory Working Group on Diphtheria (ELWGD) was formed to assist in control of the epidemic. The ELWGD is convened by the Public Health Laboratory Service in the United Kingdom and includes 15 laboratories in Europe, one in North America (Centers for Disease Control and Prevention) and the Institute of Clinical Pathology and Medical Research, Sydney. At the group's last annual meeting in Paris, reports were presented on the progress of the epidemic, control strategies and improvements in laboratory diagnosis. The group discussed the increased carriage of, and infection with, nontoxigenic Corynebacterium diphtheriae in countries with high immunisation rates, including the United Kingdom and Australia. They also considered the possible relationship between this increase and the continued diphtheria outbreak in eastern Europe. Preliminary results of molecular typing of toxigenic and nontoxigenic isolates from many parts of the world were presented. It was agreed that further epidemiological investigation is required, using a standardised ribotyping system. Comm Dis Intell 1997;21:161- 164.