Diphtheria cases surge in England as three die with disease

Cases of the highly contagious disease diphtheria have risen substantially in the past year, new figures show, with three people dying with the illness.

The rising number of cases were linked to increased spread among asylum seekers and to people catching it from their pets, according to the latest release from the UK Health Security Agency.

Toxigenic diphtheria was identified in 87 people in England last year, a jump from the 10 cases in 2021. Risk to the wider public of catching diphtheria is still very low however, the UKHSA said.

Some 72 cases of the Corynebacterium diphtheriae (C. diphtheria) strain were found among asylum seekers who had recently arrived in England.

One asylum seeked died in November last year with the disease after being held at Manston processing centre in Kent.

11 cases of the Corynebacterium ulcerans (C. ulcerans) strain were recorded in 2022, with all these cases linked to people’s pets. Two people died with this type of diphtheria. There is however no direct evidence that this strain passes through person-to-person transmission.

Toxigenic C. diphtheria is a highly contagious infection that spreads by coughs, sneezes, or through close contact with someone who is infected.

Babies and children in the UK are vaccinated against diphtheria and so cases are rare in the UK. Over the past decade, the number of diphtheria cases in England has increased from an average of 2 to more than 10 cases per year.

The incubation period for the illness is between two and five days, with a maximum of 10 days.

Gayatri Amirthalingam, Deputy Director for Public Health Programmes at UKHSA, said that the organisation’s latest annual report “shows that the number of diphtheria cases in the UK remains very low”.

The low numbers reflected the success of the vaccination programme, he said, adding: “The risk to the wider public from diphtheria is very low.”

He continued: “However, in recent years, we have seen vaccine uptake fall among young people due to the challenges posed by the pandemic and this leaves children and young people who are not fully vaccinated at risk.

“I would urge parents of children and young people who have missed out on these important vaccines to contact their school nurse, school immunisation team or GP surgery to arrange a catch-up as these vaccines offer the best protection as young people start their journey into adulthood.”

Cases of diphtheria have also been increasing across Europe and experts presenting at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) have called for improved health screening of those arriving on small boats.

Researchers found that there was “evident tranmission” of diphtheria among migrants, which they believed had occured “during travel within migrant facilities”.

They pointed to lack of vaccination amongst asylum seekers as the reason for outbreaks. They called for increased awareness of disease symptoms among border officials caring for asylum seekers.