Diphtheria in Yemen (Update 2)

The World Health Organisation (WHO) reported on 10 February 2018 that probable diphtheria cases in Yemen have reached a total of 1032 (including 64 deaths). The most affected governorates are Ibb (407) and Al Hudaydah (133). Case Fatality Ratio (CFR) is 6.1%. Children under the age of 5 years represent 30% of probable cases and 47% of deaths.

Advice to Travellers

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