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Chapter 11 : Epidemic Diphtheria in the Newly Independent States of the Former Soviet Union

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Epidemic Diphtheria in the Newly Independent States of the Former Soviet Union, Page 1 of 2

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Abstract:

In spite of decades of good control, in the newly independent states of the former Soviet Union epidemic diphtheria has reemerged. During the late 1980s, childhood immunization coverage levels were low in some regions of the Soviet Union. One of the factors contributing to lack of ontime vaccination of children was a long list of contraindications for vaccination. In the central Asian republics and Caucasian countries there were vaccine shortages due to disruption of the supply in 1992 and 1993, following the dissolution of the Soviet Union. Before the dissolution of the Soviet Union, Russian-manufactured diphtheria toxoid vaccine was used throughout the Soviet Union. Although morbidity data from the armed forces are not available to civilian public health authorities in the former Soviet Union, outbreaks of diphtheria among soldiers have been reported. High coverage among children (95% coverage with four doses of diphtheria toxoid in all districts) and administration of a single dose of diphtheria toxoid to each inhabitant were essential to achieve high population immunity. The risk of emergence of epidemic diphtheria in other countries is difficult to estimate, but clearly clinical and public health expertise in diagnosis and management of diphtheria cases must be maintained. Although previously a disease of children, diphtheria has emerged as an epidemic disease among adolescents and adults in the newly independent states of the former Soviet Union decades after the implementation of an effective childhood vaccination program.

Citation: Wharton M, Hardy I, Vitek C, Popovic T, Sutter R. 1998. Epidemic Diphtheria in the Newly Independent States of the Former Soviet Union, p 165-176. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch11

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Figures

Image of Figure 1.
Figure 1.

Reported cases of diphtheria in the Russian Federation from 1920 to 1995.

Citation: Wharton M, Hardy I, Vitek C, Popovic T, Sutter R. 1998. Epidemic Diphtheria in the Newly Independent States of the Former Soviet Union, p 165-176. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch11
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Image of Figure 2.
Figure 2.

Diphtheria incidence in the newly independent states in 1994. Incidence rates are per 100.000 persons.

Citation: Wharton M, Hardy I, Vitek C, Popovic T, Sutter R. 1998. Epidemic Diphtheria in the Newly Independent States of the Former Soviet Union, p 165-176. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch11
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Image of Figure 3.
Figure 3.

Reported diphtheria incidence and mortality due to diphtheria by age group in the Russian Federation in 1993. Dark bars, incidence: light bars. mortality; y. years. Data are from reference .

Citation: Wharton M, Hardy I, Vitek C, Popovic T, Sutter R. 1998. Epidemic Diphtheria in the Newly Independent States of the Former Soviet Union, p 165-176. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch11
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Image of Figure 4.
Figure 4.

Reported diphtheria cases by month in the Russian Federation from 1991 to 1995. Data were provided by the Stale Committee for Sanitary and Epidemiological Surveillance. Russian Federation.

Citation: Wharton M, Hardy I, Vitek C, Popovic T, Sutter R. 1998. Epidemic Diphtheria in the Newly Independent States of the Former Soviet Union, p 165-176. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch11
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Image of Figure 5.
Figure 5.

Dendrogram of genetic relationships of 76 ETs of 156 isolates from Russia, 1985 to 1994, RT. ribotype; v. variant of either M I or G4; *. nontoxigenic strain; † , family A;║ , family D;, family E; §§, multiple isolates described in detail in inset. (Reprinted from reference 26 with permission of the publisher.)

Citation: Wharton M, Hardy I, Vitek C, Popovic T, Sutter R. 1998. Epidemic Diphtheria in the Newly Independent States of the Former Soviet Union, p 165-176. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch11
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References

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