Diphtheria in Bangladesh (Cox's Bazaar)

The European Commission reports 549 suspected cases of diphtheria (including 9 deaths) among Rohingya refugees in Cox's Bazaar. Congestion, low vaccination coverage and poor sanitation are assisting spread of infection and the number of cases is expected to double every three to five days. The outbreak is expected to peak around New Year.

The World Health Organisation (WHO) and other agencies have implemented a diphtheria task force to coordinate case management, vaccination, contact tracing and laboratory testing.

Advice to Travellers

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 endemic areas particularly where individuals will be mixing with the local population (e.g. health workers, teachers, volunteers).
• Aid workers travelling to regions with confirmed diphtheria outbreaks, who are thus likely to be exposed to infection, should be given a reinforcing dose of a diphtheria-containing vaccine if they have not had one in the last 12 months. Further guidance for the management of contacts of diphtheria cases is available from Public Health England  

For further information see Diphtheria.