Diphtheria outbreak in Maranhão, Brazil: microbiological, clinical and epidemiological aspects
We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27 confirmed cases occurred in partially (n = 16) or completely (n = 10) immunized children (n = 26). Clinical signs and characteristic symptoms of diphth...
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| Published in | Epidemiology and infection Vol. 143; no. 4; pp. 791 - 798 |
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| Main Authors | , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Cambridge, UK
Cambridge University Press
01.03.2015
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| Subjects | |
| Online Access | Get full text |
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| Abstract | We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27 confirmed cases occurred in partially (n = 16) or completely (n = 10) immunized children (n = 26). Clinical signs and characteristic symptoms of diphtheria such as cervical lymphadenopathy and pseudomembrane formation were absent in 48% and 7% of the cases, respectively. Complications such as paralysis of lower limbs were observed. Three cases resulted in death, two of them in completely immunized children. Microbiological analysis identified the isolates as Corynebacterium diphtheriae biovar intermedius with a predominant PFGE type. Most of them were toxigenic and some showed a decrease in penicillin G susceptibility. In conclusion, diphtheria remains endemic in Brazil. Health professionals need to be aware of the possibility of atypical cases of C. diphtheriae infection, including pharyngitis without pseudomembrane formation. |
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| AbstractList | We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27 confirmed cases occurred in partially (n = 16) or completely (n = 10) immunized children (n = 26). Clinical signs and characteristic symptoms of diphtheria such as cervical lymphadenopathy and pseudomembrane formation were absent in 48% and 7% of the cases, respectively. Complications such as paralysis of lower limbs were observed. Three cases resulted in death, two of them in completely immunized children. Microbiological analysis identified the isolates as Corynebacterium diphtheriae biovar intermedius with a predominant PFGE type. Most of them were toxigenic and some showed a decrease in penicillin G susceptibility. In conclusion, diphtheria remains endemic in Brazil. Health professionals need to be aware of the possibility of atypical cases of C. diphtheriae infection, including pharyngitis without pseudomembrane formation. SUMMARY We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27 confirmed cases occurred in partially (n = 16) or completely (n = 10) immunized children (n = 26). Clinical signs and characteristic symptoms of diphtheria such as cervical lymphadenopathy and pseudomembrane formation were absent in 48% and 7% of the cases, respectively. Complications such as paralysis of lower limbs were observed. Three cases resulted in death, two of them in completely immunized children. Microbiological analysis identified the isolates as Corynebacterium diphtheriae biovar intermedius with a predominant PFGE type. Most of them were toxigenic and some showed a decrease in penicillin G susceptibility. In conclusion, diphtheria remains endemic in Brazil. Health professionals need to be aware of the possibility of atypical cases of C. diphtheriae infection, including pharyngitis without pseudomembrane formation. SUMMARY We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27 confirmed cases occurred in partially ( n = 16) or completely ( n = 10) immunized children ( n = 26). Clinical signs and characteristic symptoms of diphtheria such as cervical lymphadenopathy and pseudomembrane formation were absent in 48% and 7% of the cases, respectively. Complications such as paralysis of lower limbs were observed. Three cases resulted in death, two of them in completely immunized children. Microbiological analysis identified the isolates as Corynebacterium diphtheriae biovar intermedius with a predominant PFGE type. Most of them were toxigenic and some showed a decrease in penicillin G susceptibility. In conclusion, diphtheria remains endemic in Brazil. Health professionals need to be aware of the possibility of atypical cases of C. diphtheriae infection, including pharyngitis without pseudomembrane formation. We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhao, Brazil. The majority of the 27 confirmed cases occurred in partially (n = 16) or completely (n = 10) immunized children (n = 26). Clinical signs and characteristic symptoms of diphtheria such as cervical lymphadenopathy and pseudomembrane formation were absent in 48% and 7% of the cases, respectively. Complications such as paralysis of lower limbs were observed. Three cases resulted in death, two of them in completely immunized children. Microbiological analysis identified the isolates as Corynebacterium diphtheriae biovar intermedius with a predominant PFGE type. Most of them were toxigenic and some showed a decrease in penicillin G susceptibility. In conclusion, diphtheria remains endemic in Brazil. Health professionals need to be aware of the possibility of atypical cases of C. diphtheriae infection, including pharyngitis without pseudomembrane formation. We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27 confirmed cases occurred in partially (n = 16) or completely (n = 10) immunized children (n = 26). Clinical signs and characteristic symptoms of diphtheria such as cervical lymphadenopathy and pseudomembrane formation were absent in 48% and 7% of the cases, respectively. Complications such as paralysis of lower limbs were observed. Three cases resulted in death, two of them in completely immunized children. Microbiological analysis identified the isolates as Corynebacterium diphtheriae biovar intermedius with a predominant PFGE type. Most of them were toxigenic and some showed a decrease in penicillin G susceptibility. In conclusion, diphtheria remains endemic in Brazil. Health professionals need to be aware of the possibility of atypical cases of C. diphtheriae infection, including pharyngitis without pseudomembrane formation. |
| Author | SANTOS, L. S. RAMOS, J. N. COSME, L. M. S. S. LADEIRA, E. M. NAPOLEÃO, F. HIRATA, R. SABBADINI, P. S. MATTOS-GUARALDI, A. L. CAMELLO, T. C. F. SANTOS, C. S. BORGES, L. L. G. SANT'ANNA, L. O. STAVRACAKIS-PEIXOTO, R. PEREIRA, G. A. VIEIRA, V. V. |
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S. organization: Central Laboratory of Public Health, Oswaldo Cruz Institute – LACEN, São Luís, MA, Brazil – sequence: 14 givenname: P. S. surname: SABBADINI fullname: SABBADINI, P. S. organization: Laboratory of Diphtheria and Corynebacteria of Clinical Relevance, Faculty of Medical Sciences, Rio de Janeiro State University, UERJ, Rio de Janeiro, RJ – LDCIC/FCM/UERJ; The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health – FNS/MS, Brazil – sequence: 15 givenname: A. L. surname: MATTOS-GUARALDI fullname: MATTOS-GUARALDI, A. L. email: guaraldi@uerj.br organization: Laboratory of Diphtheria and Corynebacteria of Clinical Relevance, Faculty of Medical Sciences, Rio de Janeiro State University, UERJ, Rio de Janeiro, RJ – LDCIC/FCM/UERJ; The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health – FNS/MS, Brazil |
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S0950268814001241_ref18 doi: 10.1111/j.1574-6968.2002.tb11379.x – start-page: 485 volume-title: Manual of Clinical Microbiology year: 2007 ident: S0950268814001241_ref14 contributor: fullname: Funke |
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| Snippet | We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27 confirmed... SUMMARY We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27... SUMMARY We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27... We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhao, Brazil. The majority of the 27 confirmed... |
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| Title | Diphtheria outbreak in Maranhão, Brazil: microbiological, clinical and epidemiological aspects |
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