Diphtheria in Pakistan

On the 18 November 2016 the media reported a significant increase in the number of diphtheria cases in the South and North Waziristan agencies (Federally Administered Tribal Areas) of Pakistan.

The unstable security situation in Waziristan has prevented routine childhood immunisations being carried out for many years and this outbreak is thought to have spread from unvaccinated children living in internally displaced people camps in the area. Approximately 30 deaths in children have been linked to this outbreak.

A senior official of the Expanded Programme on Immunization advised that steps are being taken to control the situation, however, this is challenging due to the unstable security situation and movement of families.

Advice to Travellers

Ensure British Vaccination Schedule complete for all travellers including booster doses as teenagers.

Vaccination should be considered under the following circumstances and is dependant on the individual risk assessment:

• Individuals with an incomplete primary vaccination history for diphtheria, irrespective of region of travel.
• Ten-yearly boosters of vaccine should be given for travel to epidemic/endemic areas particularly where individuals will be mixing with the local population (e.g. health workers, teachers, volunteers).