Fatal Case of Diphtheria in Singapore

The Singapore Ministry of Health has reported a fatal case of diphtheria. The patient was a 21-year-old Bangladeshi construction worker who became unwell on 30 July. He was hospitalised on 1 August and died on 4 August. A respiratory sample was positive for toxigenic Corynebacterium diphtheriae.

This is the first case of locally-acquired diphtheria in Singapore since 1992.

Advice to Travellers

Singapore is not usually considered a destination where there is a high risk of diphtheria so the following general advice applies.

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

Travellers should be aware of:

• persistence of disease in many regions of the world to which unvaccinated individuals are susceptible
• waning immunity from diphtheria vaccine with increasing age.

When to consider vaccination

Vaccination should be considered under the following circumstances and is dependent 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).

For further information see Diphtheria.