1. Molecular and epidemiologic characterization of the diphtheria outbreak in Venezuela.
- Author
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Strauss RA, Herrera-Leon L, Guillén AC, Castro JS, Lorenz E, Carvajal A, Hernandez E, Navas T, Vielma S, Lopez N, Lopez MG, Aurenty L, Navas V, Rosas MA, Drummond T, Martínez JG, Hernández E, Bertuglia F, Andrade O, Torres J, May J, Herrera-Leon S, and Eibach D
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Corynebacterium diphtheriae isolation & purification, Corynebacterium diphtheriae pathogenicity, Diphtheria genetics, Diphtheria microbiology, Disease Outbreaks, Female, Humans, Male, Middle Aged, Multilocus Sequence Typing, Retrospective Studies, Venezuela epidemiology, Young Adult, Corynebacterium diphtheriae genetics, Diphtheria epidemiology, Phylogeny
- Abstract
In 2016, Venezuela faced a large diphtheria outbreak that extended until 2019. Nasopharyngeal or oropharyngeal samples were prospectively collected from 51 suspected cases and retrospective data from 348 clinical records was retrieved from 14 hospitals between November 2017 and November 2018. Confirmed pathogenic Corynebactrium isolates were biotyped. Multilocus Sequence Typing (MLST) was performed followed by next-generation-based core genome-MLST and minimum spanning trees were generated. Subjects between 10 and 19 years of age were mostly affected (n = 95; 27.3%). Case fatality rates (CFR) were higher in males (19.4%), as compared to females (15.8%). The highest CFR (31.1%) was observed among those under 5, followed by the 40 to 49 age-group (25.0%). Nine samples corresponded to C. diphtheriae and 1 to C. ulcerans. Two Sequencing Types (ST), ST174 and ST697 (the latter not previously described) were identified among the eight C. diphtheriae isolates from Carabobo state. Cg-MLST revealed only one cluster also from Carabobo. The Whole Genome Sequencing analysis revealed that the outbreak seemed to be caused by different strains with C. diphtheriae and C. ulcerans coexisting. The reemergence and length of this outbreak suggest vaccination coverage problems and an inadequate control strategy.
- Published
- 2021
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