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1. Diphtheria

Diphtheria Diphtheria - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Diphtheria Last reviewed: February 2019 Last updated: March 2019 Summary Diphtheria is endemic in many areas of the world and still occurs sporadically in the US. Early intervention by administering antitoxin is key to preventing systemic manifestations of the disease, which can include respiratory and neurological symptoms, cardiovascular collapse (...) , and death. Prompt administration of antitoxin is necessary to enable it to bind to and de-activate the free toxin in serum. Antitoxin cannot de-activate toxin once it has entered cells, which is signalled by the presence of mucocutaneous symptoms. Patients with respiratory diphtheria are placed in respiratory isolation (masks and standard measures such as hand-washing), and those with cutaneous diphtheria are placed in contact isolation (gloves and gowns), until cultures taken after cessation of therapy

2019 BMJ Best Practice

2. Diphtheria, tetanus, acellular pertussis and inactivated poliomyelitis vaccine (dTaP/IPV) for pregnant women: patient group direction (PGD) template

Diphtheria, tetanus, acellular pertussis and inactivated poliomyelitis vaccine (dTaP/IPV) for pregnant women: patient group direction (PGD) template application/vnd.openxmlformats-officedocument.wordprocessingml.document

2019 Public Health England

3. Distinct Genomic Features Characterize Two Clades of Corynebacterium diphtheriae: Proposal of Corynebacterium diphtheriae Subsp. diphtheriae Subsp. nov. and Corynebacterium diphtheriae Subsp. lausannense Subsp. nov. (PubMed)

Distinct Genomic Features Characterize Two Clades of Corynebacterium diphtheriae: Proposal of Corynebacterium diphtheriae Subsp. diphtheriae Subsp. nov. and Corynebacterium diphtheriae Subsp. lausannense Subsp. nov. Corynebacterium diphtheriae is the etiological agent of diphtheria, a disease caused by the presence of the diphtheria toxin. However, an increasing number of records report non-toxigenic C. diphtheriae infections. Here, a C. diphtheriae strain was recovered from a patient (...) with a past history of bronchiectasis who developed a severe tracheo-bronchitis with multiple whitish lesions of the distal trachea and the mainstem bronchi. Whole-genome sequencing (WGS), performed in parallel with PCR targeting the toxin gene and the Elek test, provided clinically relevant results in a short turnaround time, showing that the isolate was non-toxigenic. A comparative genomic analysis of the new strain (CHUV2995) with 56 other publicly available genomes of C. diphtheriae revealed

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2018 Frontiers in microbiology

5. Diphtheria

Diphtheria Diphtheria - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Diphtheria Last reviewed: February 2019 Last updated: March 2019 Summary Diphtheria is endemic in many areas of the world and still occurs sporadically in the US. Early intervention by administering antitoxin is key to preventing systemic manifestations of the disease, which can include respiratory and neurological symptoms, cardiovascular collapse (...) , and death. Prompt administration of antitoxin is necessary to enable it to bind to and de-activate the free toxin in serum. Antitoxin cannot de-activate toxin once it has entered cells, which is signalled by the presence of mucocutaneous symptoms. Patients with respiratory diphtheria are placed in respiratory isolation (masks and standard measures such as hand-washing), and those with cutaneous diphtheria are placed in contact isolation (gloves and gowns), until cultures taken after cessation of therapy

2018 BMJ Best Practice

6. Whole genome sequencing suggests transmission of <i>Corynebacterium diphtheriae</i>-caused cutaneous diphtheria in two siblings, Germany, 2018. (PubMed)

Whole genome sequencing suggests transmission of Corynebacterium diphtheriae-caused cutaneous diphtheria in two siblings, Germany, 2018. In September 2018, a child who had returned from Somalia to Germany presented with cutaneous diphtheria by toxigenic Corynebacterium diphtheriae biovar mitis. The child's sibling had superinfected insect bites harbouring also toxigenic C. diphtheriae. Next generation sequencing (NGS) revealed the same strain in both patients suggesting very recent human (...) -to-human transmission. Epidemiological and NGS data suggest that the two cutaneous diphtheria cases constitute the first outbreak by toxigenic C. diphtheriae in Germany since the 1980s.

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2019 Euro Surveillance

7. VAXELIS, hexavalent vaccine against diphtheria, tetanus, poliomyelitis, pertussis, Haemophilus influenzae type b infections, hepatitis B

VAXELIS, hexavalent vaccine against diphtheria, tetanus, poliomyelitis, pertussis, Haemophilus influenzae type b infections, hepatitis B Haute Autorité de Santé - VAXELIS, vaccin hexavalent contre diphtérie, tétanos, poliomyélite, coqueluche, infections à Haemophilus influenzae type b, hépatite B Développer la qualité dans le champ sanitaire, social et médico-social Recherche Évaluation & Recommandation La HAS Accréditation & Certification Outils, Guides & Méthodes Agenda Avis sur les

2018 Haute Autorite de sante

8. Diphtheria vaccine: WHO position paper – August 2017– Vaccin antidiphtérique: Note de synthèse de l’OMS – août 2017

Diphtheria vaccine: WHO position paper – August 2017– Vaccin antidiphtérique: Note de synthèse de l’OMS – août 2017 Diphtheria vaccine: WHO position paper – August 2017– Vaccin antidiphtérique: Note de synthèse de l’OMS – août 2017 JavaScript is disabled for your browser. Some features of this site may not work without it. Toggle navigation Toggle navigation Search Browse Statistics Related Links Diphtheria vaccine: WHO position paper – August 2017– Vaccin antidiphtérique: Note de synthèse de (...) l’OMS – août 2017 View/ Open View Statistics Altmetrics Share Citation World Health Organization = Organisation mondiale de la Santé . (‎2017)‎. Diphtheria vaccine: WHO position paper – August 2017– Vaccin antidiphtérique: Note de synthèse de l’OMS – août 2017. Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 92 (‎31)‎, 417 - 435. World Health Organization = Organisation mondiale de la Santé. Journal Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 92 (‎31

2017 WHO

9. Update on Immunization and Pregnancy Tetanus Diphtheria and Pertussis Vaccination

Update on Immunization and Pregnancy Tetanus Diphtheria and Pertussis Vaccination Update on Immunization and Pregnancy Tetanus Diphtheria and Pertussis Vaccination - ACOG Menu ▼ Update on Immunization and Pregnancy Tetanus Diphtheria and Pertussis Vaccination Page Navigation ▼ Number 718, September 2017 (Replaces Committee Opinion 566, June 2013) Committee on Obstetric Practice Immunization and Emerging Infections Expert Work Group This Committee Opinion was developed by the Immunization (...) , or consequential damages, incurred in connection with this publication or reliance on the information presented. Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination ABSTRACT: The overwhelming majority of morbidity and mortality attributable to pertussis infection occurs in infants who are 3 months and younger. Infants do not begin their own vaccine series against pertussis until approximately 2 months of age. This leaves a window of significant vulnerability for newborns, many

2017 American College of Obstetricians and Gynecologists

10. Changes in MLST profiles and biotypes of Corynebacterium diphtheriae isolates from the diphtheria outbreak period to the period of invasive infections caused by nontoxigenic strains in Poland (1950-2016). (PubMed)

Changes in MLST profiles and biotypes of Corynebacterium diphtheriae isolates from the diphtheria outbreak period to the period of invasive infections caused by nontoxigenic strains in Poland (1950-2016). Corynebacterium diphtheriae is a re-emerging pathogen in Europe causing invasive infections in vaccinated persons and classical diphtheria in unvaccinated persons. In the presented study we analysed genetic changes in C. diphtheriae isolates collected in Poland from the period before (...) the introduction of the mass anti-diphtheria vaccination to the present time when over 98% of the population is vaccinated.A total of 62 C. diphtheriae isolates collected in the 1950s-1960s, 1990s and 2000-2016 in Poland were investigated. Examined properties of the isolates included toxigenic status, presence of tox gene, biotype, MLST type (ST) and type of infection.A total of 12 sequence types (STs) were identified among the analysed C. diphtheriae isolates. The highest variability of STs was observed among

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2018 BMC Infectious Diseases

11. Mapping diphtheria-pertussis-tetanus vaccine coverage in Africa, 2000-2016: a spatial and temporal modelling study. (PubMed)

Mapping diphtheria-pertussis-tetanus vaccine coverage in Africa, 2000-2016: a spatial and temporal modelling study. Routine childhood vaccination is among the most cost-effective, successful public health interventions available. Amid substantial investments to expand vaccine delivery throughout Africa and strengthen administrative reporting systems, most countries still require robust measures of local routine vaccine coverage and changes in geographical inequalities over time.This analysis (...) drew from 183 surveys done between 2000 and 2016, including data from 881 268 children in 49 African countries. We used a Bayesian geostatistical model calibrated to results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017, to produce annual estimates with high-spatial resolution (5 ×    5 km) of diphtheria-pertussis-tetanus (DPT) vaccine coverage and dropout for children aged 12-23 months in 52 African countries from 2000 to 2016.Estimated third-dose (DPT3) coverage

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2019 Lancet

12. Biophysical comparison of diphtheria and tetanus toxins with the formaldehyde-detoxified toxoids, the main components of diphtheria and tetanus vaccines (PubMed)

Biophysical comparison of diphtheria and tetanus toxins with the formaldehyde-detoxified toxoids, the main components of diphtheria and tetanus vaccines 28430538 2018 10 09 2018 11 13 2150-5608 8 8 2017 11 17 Virulence Virulence Biophysical comparison of diphtheria and tetanus toxins with the formaldehyde-detoxified toxoids, the main components of diphtheria and tetanus vaccines. 1880-1889 10.1080/21505594.2017.1321726 Alsarraf Husam H a Department of Microbiology and Infection Control (...) Vaccine Department , Statens Serum Institut , Copenhagen S. , Denmark. Jørgensen René R a Department of Microbiology and Infection Control , Statens Serum Institut , Copenhagen S. , Denmark. eng Comparative Study Journal Article Research Support, Non-U.S. Gov't 2017 05 16 United States Virulence 101531386 2150-5594 0 Diphtheria Toxin 0 Diphtheria Toxoid 0 Tetanus Toxin 0 Tetanus Toxoid 0 Toxoids 1HG84L3525 Formaldehyde IM Clostridium tetani genetics physiology Corynebacterium diphtheriae genetics

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2017 Virulence

13. Characterization of serum anti-diphtheria antibody activity following administration of equine anti-toxin for suspected diphtheria (PubMed)

Characterization of serum anti-diphtheria antibody activity following administration of equine anti-toxin for suspected diphtheria There is a global shortage of equine-derived diphtheria anti-toxin (DAT) for diphtheria treatment. There are few existing data on serum antibody concentrations and neutralizing activity post-treatment to support development of new therapeutics. Antibody concentrations were quantified by ELISA and anti-toxin neutralizing activity by cytotoxicity assay in serum from 4 (...) patients receiving DAT for suspected diphtheria. Using linear mixed effects modeling, estimated mean (SE) half-life was 78.2 (20.0) hours. Maximum serum neutralizing activity ranged from 28.42-38.64 AU/mL with an estimated mean AUC1-72 of 1396.7 (399.3) AU/mL*hr. These data provide a standard of comparison for development of novel anti-toxins to replace DAT.

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2017 Human vaccines & immunotherapeutics

14. Six-month follow up of a randomized clinical trial-phase I study in Indonesian adults and children: Safety and immunogenicity of Salmonella typhi polysaccharide-diphtheria toxoid (Vi-DT) conjugate vaccine. (PubMed)

Six-month follow up of a randomized clinical trial-phase I study in Indonesian adults and children: Safety and immunogenicity of Salmonella typhi polysaccharide-diphtheria toxoid (Vi-DT) conjugate vaccine. There is a high global incidence of typhoid fever, with an annual mortality rate of 200,000 deaths. Typhoid fever also affects younger children, particularly in resource-limited settings in endemic countries. Typhoid vaccination is an important prevention tool against typhoid fever. However (...) , the available polysaccharide typhoid vaccines are not recommended for children under 2 years of age. A new typhoid conjugate Vi-diphtheria toxoid (Vi-DT) vaccine has been developed for infant immunization. We aimed to define the safety and immunogenicity of the Vi-DT vaccine among adults and children in Indonesia.An observational, blinded, comparative, randomized, phase I safety study in two age de-escalating cohorts was conducted in East Jakarta, Indonesia, from April 2017 to February 2018. We enrolled 100

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2019 PLoS ONE

15. Prenatal Tetanus, Diphtheria, Acellular Pertussis Vaccination and Autism Spectrum Disorder

Prenatal Tetanus, Diphtheria, Acellular Pertussis Vaccination and Autism Spectrum Disorder : media-1vid110.1542/5803567555001PEDS-VA_2018-0120Video Abstract BACKGROUND: Increasing vaccination of pregnant women makes it important to assess safety events potentially linked to prenatal vaccination. This study investigates the association between prenatal tetanus, diphtheria, acellular pertussis (Tdap) vaccination and autism spectrum disorder (ASD) risk in offspring.This is a retrospective cohort

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2018 EvidenceUpdates

16. Risk factors for diphtheria infection and persistent transmission: a systematic review

Risk factors for diphtheria infection and persistent transmission: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites

2019 PROSPERO

17. Expression and purification of truncated diphtheria toxin, DT386, in Escherichia coli: An attempt for production of a new vaccine against diphtheria (PubMed)

Expression and purification of truncated diphtheria toxin, DT386, in Escherichia coli: An attempt for production of a new vaccine against diphtheria The aim of this study was to produce a recombinant protein consisting of the catalytic and translocation domains of diphtheria toxin for its later application as a vaccine candidate against Corynebacterium diphtheria. To achieve this goal, at first, the amino acid sequence of DT386 was used for prediction of T and B cell epitopes using on-line (...) , the recombinant protein was purified using nickel affinity chromatography. The results of epitope prediction using on-line servers established the ability of DT386 for stimulation of immune system against diphtheria toxin. Restriction digestion of the recombinant plasmids using NcoI and XhoI enzymes confirmed the fidelity of cloning by producing a band of about 1200 bp. SDS-PAGE analysis following induction of expression and also purification step confirmed the expression of the desired protein by showing

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2016 Research in pharmaceutical sciences

18. Potency of a human monoclonal antibody to diphtheria toxin relative to equine diphtheria anti-toxin in a guinea pig intoxication model (PubMed)

Potency of a human monoclonal antibody to diphtheria toxin relative to equine diphtheria anti-toxin in a guinea pig intoxication model Prompt administration of anti-toxin reduces mortality following Corynebacterium diphtheriae infection. Current treatment relies upon equine diphtheria anti-toxin (DAT), with a 10% risk of serum sickness and rarely anaphylaxis. The global DAT supply is extremely limited; most manufacturers have ceased production. S315 is a neutralizing human IgG1 monoclonal (...) antibody to diphtheria toxin that may provide a safe and effective alternative to equine DAT and address critical supply issues. To guide dose selection for IND-enabling pharmacology and toxicology studies, we dose-ranged S315 and DAT in a guinea pig model of diphtheria intoxication based on the NIH Minimum Requirements potency assay. Animals received a single injection of antibody premixed with toxin, were monitored for 30 days, and assigned a numeric score for clinical signs of disease. Animals

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2016 Virulence

19. Booster vaccination against tetanus and diphtheria: insufficient protection against diphtheria in young and elderly adults (PubMed)

Booster vaccination against tetanus and diphtheria: insufficient protection against diphtheria in young and elderly adults We have recently demonstrated that single shot vaccinations against tetanus and diphtheria do not lead to long-lasting immunity against diphtheria in elderly persons despite administration at 5 year intervals. In the present study we have immunized a group of young adults against tetanus and diphtheria to compare the pre- and 28 days post-vaccination immune responses (...) in the young group with results of the same vaccination performed in an elderly group of a previous study. We also studied protection in both groups 5 years after vaccination. We compared antibody titers at all three time points and also analyzed the T cell responses in both age groups 5 years after vaccination. Before vaccination 9 % of the elderly persons were not protected against tetanus, and 48 % did not have protection against diphtheria. In the young group all participants were protected against

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2016 Immunity & ageing : I & A

20. Clinico-epidemiological profile and predictors of outcome in children with diphtheria: a study from northern India. (PubMed)

Clinico-epidemiological profile and predictors of outcome in children with diphtheria: a study from northern India. Diphtheria, a vaccine preventable disease in children, is still being reported from India. Details of 99 children with a clinical diagnosis of diphtheria admitted to a paediatric tertiary care teaching and referral hospital between January 2008 and December 2015 were collected retrospectively and analysed. The median (interquartile range [IQR]) age of the study group was 7.0 years (...) (IQR = 5.0-8.0 years). Nearly two-thirds were unimmunised. Clinical features included fever (97%), dysphagia (82%), sore throat (67%), bull neck (54%), stridor (40%), neuropathy (27%) and nasal discharge (14%). Throat swab for Albert stain was positive in only 21% of cases and C. diphtheriae was isolated in only 28%. Complications included airway compromise (61.7%) followed by myocarditis (35.4%), acute kidney injury (22.3%), thrombocytopenia (25.3%) and neuropathy (27.3%). In all, 66% survived, 23

2019 Tropical Doctor

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