Public health round-up

Supplies of diphtheria antitoxin are urgently needed worldwide for people with confirmed or suspected diphtheria disease to improve their chances of survival, according to a World Health Organization (WHO) expert group. The Strategic Advisory Group of Experts on Immunization, which met at the end of April, called on WHO to collaborate with its partners to establish and manage a global procurement mechanism and a physical or virtual stockpile of diphtheria antitoxin. Diphtheria is a forgotten disease in much of the world and needs global attention, the expert group said. Progress in reducing the number of new cases of diphtheria has stalled in the last 5 years, with approximately 5000 cases reported a year, the group noted, citing data collected by WHO and the United Nations Children’s Fund. Most diphtheria cases occur in people who have not been vaccinated at all or in those who have not had a full course of primary vaccination and booster doses, the group said. In humans, diphtheria can cause a severe infection of the throat that can lead to respiratory failure and death. The first line of defence against diphtheria is vaccination. Suspected and confirmed cases should be treated with diphtheria antitoxin, a medicine that is included on the WHO Model list of essential Medicines. The expert group also called for regulatory pathways to ensure the rapid deployment of diphtheria antitoxin. Members of the group highlighted the need for strengthening surveillance systems to detect and investigate diphtheria cases. Better data is needed to inform vaccination schedules, prevent outbreaks and to enable a prompt response to outbreaks when they occur. Governments should report diphtheria cases caused by C. diphtheria and C. ulcerans, where laboratory capacity for confirmation is available, the expert group said. http://www.who.int/immunization/ sage/meetings/2017/April