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Bangladesh: Diphtheria Outbreak - 2017-2019

Status
Past
Countries
Bangladesh
Disaster types
Epidemic

Diphtheria is rapidly spreading among Rohingya refugees in Cox’s Bazar, Bangladesh, the WHO warned. More than 110 suspected cases, including 6 deaths, have been clinically diagnosed by health partners, including Médecins Sans Frontières (MSF) and IFRC. (WHO, 6 Dec 2017)

The Government of Bangladesh, with the support of UNICEF, WGO and GAVI, the Vaccine Alliance, launched a vaccination campaign against diphtheria and other preventable diseases for all Rohingya children aged six weeks to six years living in 12 camps and temporary settlements near the Myanmar border. Accelerated immunization will cover nearly 255,000 children in the Ukhiya and Teknaf sub-districts in Cox’s Bazar, while the Government and health partners continue to increase support for diphtheria treatment and prevention. (WHO, 12 Dec 2017)

From 3 November through 12 December 2017, a total of 804 suspected diphtheria cases including 15 deaths were reported among the displaced Rohingya population in Cox’s Bazar. The first suspected case was reported on 10 November by a MSF clinic in Cox’s Bazar. Of the suspected cases, 73 per cent are younger than 15 years of age...Fourteen of the 15 deaths reported among suspected diphtheria cases were children younger than 15 years of age. (WHO, 13 Dec 2017)

WHO has released US$1.5 million from its Contingency Fund for Emergencies to help finance scaling up of health operations in Cox’s Bazar over the next six months, in efforts to respond to an outbreak that has seen more than 1,500 probable cases, including 21 deaths. (WHO, 19 Dec 2017)

As of 31 December, 28 deaths and 3,014 suspected cases of diphtheria have been reported from Cox’s Bazar. Nearly 10,594 contacts of these suspected cases have been put on diphtheria preventive medication. (WHO, 2 Jan 2018)

WHO and UNICEF are working with Ministry of Health and Family Welfare to vaccinate over 350,000 children in the Rohingya camps and makeshift settlements with an additional dose of diphtheria vaccine. So far, 4,800 suspected cases of diphtheria and 35 deaths have been reported in Cox’s Bazar. Thirty-seven of the suspected cases were in host communities. (WHO & UNICEF, 28 Jan 2018)

As of 27 January 2018, a total of 4907 cases clinically suspected with diphtheria have been reported. Of these, laboratory specimen information was reported for 269 cases, 88 (32.7%) of which tested positive by PCR. A total of 35 deaths have been recorded as of 27 January. Reports of diphtheria have stabilized at 50-60 case-patients per day over the last 10 days which is consistent with diphtheria antitoxin use. (WHO, 29 Jan 2018)

As of 1 March 2018, 5,882 suspected diphtheria cases including 38 deaths have been reported, with 171 cases in the week of 23 February. This is a declining trend from 219 and 280 cases in the preceding two weeks. The third round of diphtheria vaccination will be held from 10 to 25 March with increased focus on communicating the importance of this campaign to the community. Independent monitoring in round two led to estimates that up to 60,000 children were missed. (UNICEF, 1 Mar 2018).

On 10 March 2018, the number of suspected cases rose to 6,132 (WHO, 13 Mar 2018)

As of 24 April 2018, a total 6,780 suspected cases of diphtheria have been reported. Cases continue to be reported amongst children aged 5‐14 years. No deaths were reported in week 16. During the same week, seven cases were reported from the host community, bringing the total to 64 cases. (WHO, 26 Apr 2018)

As of 28 April 2018, 6,822 cases of diphtheria with 42 deaths, including 216 cases in the last two weeks, were reported. In host communities, a total of 56 cases were reported with no deaths. (UNICEF, 5 May 2018).

As of 19 May 2018, there were 6,918 diphtheria case-patients reported through EWARS and an additional 653 case-patients were tested negative on PCR. No new deaths were reported in last four weeks. (WHO, Gov't of Bangladesh, 22 May 2018)

As of 26 May 2018, there have been 6,949 diphtheria case-patients reported through EWARS, and an additional 681 case-patients were tested negative on PCR. A total of 47 new case-patients were reported, which is slightly lower compared to previous week. Total of 42 diphtheria deaths have reported, no new death was reported this week. (WHO, 31 May 2018)

As of 2 June 2018, there were 7,682 diphtheria case-patients reported through EWARS, including 686 case-patients who were tested negative by PCR. This week 51 new case-patients (updated counts as of 5 June 2018) were reported which is slightly lower than previous week (57 case-patients in week 21). (WHO, Gov't of Bangladesh, 5 June 2018)

As of 30 June, a total of 7,888 diphtheria case-patients were reported through EWARS, including 245 case-patients tested positive and 778 tested negative on PCR. 65 new case-patients reported which is higher than previous week. One death reported this week. Total number of deaths = 44. (WHO, Gov't of Bangladesh, 30 June 2018)

As of 24 July, a total of 8,031 diphtheria case-patients were reported through EWARS, including 261 case-patients tested positive and 913 tested negative on PCR. During week 29, 34 new case-patients reported which is lower than the previous week. (WHO, Gov't of Bangladesh, 24 Jul 2018)

As of 2 August, 85 cases of diphtheria without death were reported during the past two weeks bringing the total to 8,031 cases with 44 deaths since 8 November 2017. (UNICEF, 2 Aug 2018)

In week 36, Diphtheria contact tracing was conducted for a total of 3 cases (35 contacts). Since inception, contact tracing has been conducted for a total of 1,119 cases. In total, 7,769 contacts have been traced and provided with chemoprophylaxis (IOM, 13 Sep 2018)

Diphtheria contact tracing was conducted for a total of 2 cases (21 contacts) in week 37. Since inception of this activity, contact tracing has been conducted for a total of 1,121 cases, with 7,790 contacts traced and provided with chemoprophylaxis. (IOM, 20 Sep 2018)

In week 38, no diphtheria cases were reported. This is the first week in which zero cases were reported since the start of the outbreak. Diphtheria and oral cholera vaccination campaigns were extended among host community surrounding the refugees and Diphtheria case investigation were undertaken among host community including laboratory investigations. (ISCG, 27 Sep 2018)

As of 2 Oct, 32 diphtheria case-patients were tested by PCR from 12 to 29 September 2018. Of these, 5 were tested positive and the rests were negative. The most recent positive case-patient was tested on 29 September 2018. This suggests that there are pockets of population not fully immunized despite three mass diphtheria campaigns. (WHO, 2 Oct 2018)

As of 8 October, the health sector recorded zero case of diphtheria with no deaths, bringing the total cases since 8 November to 8,176 cases with 44 recorded deaths. Despite the declining trend, the transmission risk is still present as the latest confirmed cases occured on 5 September 2018. (UNICEF, 8 Oct 2018)

As of 30 October, 11 new diphtheria case-patients (1 probable and 10 suspected) were reported this week. Total case patients reported in EWARS is 8,262. Till now 278 case-patients were tested positive on PCR (last Confirmed reported on 10 October 2018). Among other cases 2,706 case-patients were classified as probable and 5,278 case-patients were classified as suspected. (WHO, 30 Oct 2018)

Six new diphtheria case-patients (all suspected) were reported during the week of 31 October to 6 November. Total case-patients reported in EWARS is now 8,271. Of these, 281 case patients have tested positive on PCR, with the last confirmed case reported on 24 October 2018. Of the remaining cases 2,705 were classified as probable and 5,285 as suspected. The total number of deaths remains 44. (WHO, 6 Nov 2018)

A total of 11 new diphtheria case-patients (1 confirmed and other suspected) were reported during the week of 7-13 November. Total case-patients reported in EWARS is now 8,282. Of these, 283 case patients have tested positive on PCR, with the last confirmed case reported on 6 November. Of the remaining cases 2,705 were classified as probable and 5,294 as suspected. The total number of deaths remains 44. Last death was reported on 28 June 2018. (WHO, 15 Nov 2018)

During the week of 14 - 20 November, ten new diphtheria case‐patients (3 probable and 7 suspected) were reported this week. Total case‐patients reported in EWARS is now 8,293. Of these, 283 case patients have tested positive on PCR. Of the remaining cases 2,708 were classified as probable and 5,298 as suspected. The total number of deaths remains 44. (WHO, 22 Nov 2018)

Eight new diphtheria case-patients (1 confirmed and 7 suspected) were reported during 21-27 November. Total case-patients reported in EWARS is now 8,302. Of these, 285 case patients have tested positive on PCR. Of the remaining cases 2,707 were classified as probable and 5,310 as suspected. The total number of deaths remains 44. (WHO, 22 Nov 2018)

During 28 November to 4 December, 16 new diphtheria case-patients (4 probable and 12 suspected) were reported this week. Total case-patients reported in EWARS is now 8,322. Of these, 285 case patients have tested positive on PCR, with the last confirmed case reported on 20 November. Of the remaining cases 2,711 were classified as probable and 5,326 as suspected. The total number of deaths remains 44. (WHO, 4 Dec 2018)

A total of three new diphtheria case-patients (all suspected) were reported during 11-17 December. Total casepatients reported in EWARS is now 8,327. Of these, 290 case patients have tested positive on PCR, with the last confirmed case reported on 29 November. Of the remaining cases 2 709 were classified as probable and 5,336 as suspected. The total number of deaths remains 44. (WHO, 21 Dec 2018)

As of 27 December 2018, total case-patients reported in EWARS is now 8,339. Of these, 290 case patients have tested positive on PCR. 2,710 were classified as probable and 5,339 as suspected. The total number of deaths remains 44. Four new diphtheria case-patients (all suspected) were reported during the week of 18-24 December 2018. (WHO, 27 Dec 2018)

As of 17 January 2019, the total case‐patients reported in EWARS is now 8 372. Of these, 293 case patients have tested positive on PCR, with the last confirmed case reported on 31 December 2018. Of the remaining cases 2 710 were classified as probable and 5 369 as suspected. The total number of deaths remains at 44. (WHO, 17 Jan 2019)

During the 2nd and 4th week of January 2019, thirteen new diphtheria case-patients (all suspected) were reported. Total case-patients reported in EWARS is now 8,403. Of these, 293 case patients have tested positive on PCR, with the last confirmed case reported on 31 December 2018. Of the remaining cases 2 710 were classified as probable and 5,396 as suspected. The total number of deaths reported due to diphtheria so far is 45. Last death was reported on 15 January 2019. (WHO, 31 Jan 2019)

During 10 - 28 February 2019, twenty new diphtheria case-patients (all suspected) were reported. Total case-patients reported in EWARS is now 8,455. Of these, 293 case patients have tested positive on PCR, with the last confirmed case reported on 31 December 2018. Of the remaining cases 2,719 were classified as probable and 5,443 as suspected. The total number of deaths reported due to diphtheria so far is 45. Last death was reported on 15 January 2019. (WHO, 28 Feb 2019)

Twenty new diphtheria case-patients (all suspected) were reported in weeks 9 and 10. Total case-patients reported in EWARS is now 8 474...The total number of deaths reported due to diphtheria so far is 45. Last death was reported on 15 January 2019. (WHO, 14 Mar 2019)

Thirteen new diphtheria case-patients were reported in week 11 (1 probable and 12 suspected) but no case-patient was reported in week 12. Of these, 294 case-patients have tested positive on PCR, with the last confirmed case reported on 12 February 2019. Of the remaining cases 2 726 were classified as probable and 5 483 as suspected. The total number of deaths reported since the start of the outbreak since is 45. Last death was reported on 15 January 2019. (WHO, 29 Mar 2019)

There have been 172 diphtheria cases reported so far in 2019, bringing it the total to 8,518 cases since the beginning of the outbreak in November 2017. The last death was reported on 15 January 2019 (45 deaths have been reported in total). Routine immunization continues in camps to prevent the further spread of diseases; 2,710 children received their third dose of pentavalent vaccine in March 2019, indicating they are on track to have received their full schedule of vaccinations. (UNICEF, 31 Mar 2019)

Ten new diphtheria case-patients were reported between March 24 and April 6, 2019 (1 confirmed, 9 suspected), which brings the total number of reported case-patients to 8,545. Of these, 295 case-patients were confirmed by PCR. Based on clinical presentation other case-patients were classified as probable (2,728) and suspected (5,522). In 2019,199 case-patients have been reported, of which 3 were confirmed by PCR, 19 were probable and 177 were suspected. The total number of deaths reported due to diphtheria since the start of the outbreak since is 45. Last death was reported on 15 January 2019. (WHO, 11 Apr 2019)

Fourteen new diphtheria patients were reported in week 16 in EWARS. A total of 8580 diphtheria patients have been reported in EWARS since the beginning of the emergency, out of which 295 were classified as confirmed cases after laboratory testing. Others were classified as probable (2728) and suspected (5557) cases. (WHO, 25 Apr 2019)

Fourteen new diphtheria case-patients were reported in week 18 in EWARS, which was less than the number reported in week 17 (17 cases). A total 8,612 diphtheria case-patients were reported in EWARS. Out of these, 295 were classified as confirmed cases after laboratory testing. Others were classified as probable (2,729) and suspected (5,558) cases. In 2019, a total of 266 diphtheria case-patients were reported including 3 confirmed, 20 probable and 243 suspected cases. (WHO, 9 May 2019)

Six new diphtheria case-patients were reported in week 20 in EWARS, which is similar to week 19 (7 cases). A total of 8,626 diphtheria case-patients were reported in EWARS. Out of these, 295 were classified as confirmed cases after laboratory testing. Others were classified as probable 730, and suspected (5 601) cases. In 2019, total of 280 diphtheria case-patients were reported including 3 confirmed, 21 probable and 256 suspected cases. (WHO, 23 May 2019)

Four new diphtheria case-patients (all suspected) were reported in week 22 in EWARS which is less than previous week (8 cases). A total of 8,640 diphtheria case-patients have been reported in EWARS since the start of the outbreak. Out of these, 296 were classified as confirmed cases after laboratory testing. Others were classified as probable (2,729) and suspected (5,615) cases. In 2019, a total of 294 diphtheria case-patients were reported including 4 confirmed, 20 probable and 270 suspected cases. (WHO, 9 Jun 2019)

There has been one new suspected case of diphtheria reported in the past two weeks with an onset date in week 22. A total of 8,641 diphtheria case-patients have been reported in EWARS since the start of the outbreak. Out of these, 296 were classified as confirmed cases after laboratory testing. Others were classified as probable (2,729) and suspected (5,616) cases. In 2019, a total of 295 diphtheria case-patients were reported including 4 confirmed, 20 probable and 271 suspected cases. (WHO, 20 Jun 2019)