Diphtheria outbreak – the Government must drop its complacency and step-up testing, warns expert

As suspected diphtheria cases rise across the UK, a testing expert says Brits’ childhood vaccinations may not be enough to stop the infection from spreading.

An outbreak of diphtheria in the UK has led to one death and at least 70 suspected cases. The potentially lethal infection was first detected at the Manston migrant processing centre in Kent and has become more widespread with the dispersal of refugees across the country. Reported cases of this highly contagious disease have almost doubled, from 39 people on 10 November to 70 suspected cases on 27 November.

The Health Minister Steve Barclay declared this week that the risk to the public was ‘very low, partly because there's very high uptake of vaccination within the British public in the first place.’ However, a leading testing expert says the Government should not be too complacent about the risk posed by the recent spread of diphtheria.

The leading testing expert, Dr Quinton Fivelman PhD, Chief Scientific Officer at London Medical Laboratory, says: ‘Diphtheria can be deadly in 5-10% of cases. While it’s true that most Brits were routinely vaccinated against this highly contagious bacterial infection, most of us had our final diphtheria vaccination when we were around the age of 14. The NHS official guidance is that people at risk of contact with diphtheria may need a booster if they were last vaccinated more than 10 years ago. That’s most UK adults, some of whom may have been exposed to the disease in the last few weeks.

‘Our understanding is that from Monday 28 November, migrants displaying symptoms are now being isolated at Manston or “designated isolation centres” similar to the “isolation hotels” used at the height of the Covid pandemic. That’s a little like shutting the barn door after the horse has bolted and does not address the issue of cases pre-dating Monday. The Government’s poor planning has resulted in a public health risk that could have been easily avoided.

‘Following adverse publicity about poor conditions at Manston, migrants were rapidly dispersed throughout Britain before the infection was identified. The fear is that diphtheria has now spread to locations nationwide. The latest UK Health Security Agency (UKHSA) report says 38 cases have been reported in the south-east, with cases also detected across London, the West Midlands and the north-east of England.

‘Testing for diphtheria can be done rapidly using a PCR test. Often, this is then supported by Elek’s test – a specialist diphtheria test – that takes longer. We recommend, at the very least, the introduction of localised PCR testing in the areas former Manston residents have been dispersed to.

‘The concern is that the bacterial infection spreads easily by coughs and sneezes, or through close contact with someone who is infected. Sharing cutlery or cups, or even coming into contact with clothing from an infected person, could expose people to the infection.

Diphtheria symptoms

‘Diphtheria was once one of the most feared childhood diseases in the UK, with around 60,000 cases a year. This dramatically reduced following the introduction of mass immunisation in 1942.

‘A 2020 study on diphtheria in the UK revealed around 75% of the population has antibody levels high enough to give basic diphtheria protection. The highest number of susceptible individuals was observed in under 1-year-olds (37%), 35–44-year-olds (27%), 45–69-year-olds (41%) and those older than 70 years (33%). These figures, perhaps, reflect a combination of waning immunity and the fact that older people received fewer doses of the vaccination.

‘Anyone who is concerned about potential exposure to the infection should be aware of the following symptoms, which may develop around 2 to 5 days after becoming infected:

• a high temperature (fever)
• sore throat
• swollen glands in your neck
• difficulty breathing and swallowing
• a thick, grey-white coating that may cover the back of your throat, nose and tongue

‘If the skin has become infected (cutaneous diphtheria), look for these symptoms:

• blisters on the legs, feet and hands
• large ulcers surrounded by sore red skin

‘The good news is that antibiotics are highly effective if treatment is started soon enough. That means health professionals in all the areas migrants were dispersed to should be alerted to the potential presence of the bacteria.

‘With widespread diphtheria testing not yet easily available, a general health test might be a useful course of action for anyone concerned, to ensure they are in good health to help fight infections. London Medical Laboratory’s Health Profile Test provides people with a comprehensive check-up of their general health, including vitamin D levels, diabetes (HbA1c), liver & kidney function, full blood count, bone health, iron levels and a full cholesterol profile.

‘It can be taken at home through the post, or at one of the many drop-in clinics that offer this test across London and nationwide in over 85 selected pharmacies and health stores. For full details, see: https://www.londonmedicallaboratory.com/product/general-health