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Microbiological surveillance of diphteria in Europe

Objective

Objectives:
- To form a network of Diphtheria Reference Centers within Europe.
- To further improve communication and exchange of information between European centers on the occurrence and epidemiology of diphtheria and improve laboratory based surveillance.
- To standardise and disseminate public health methodologies and protocols for microbiological surveillance in order to improve the effectiveness of EU wide prevention of this resurgent disease.
- To establish a core set of clinical and epidemiological data items to accompany, where possible each laboratory confirmed case of diphtheria in Europe.
- To introduce a European international quality assurance scheme for laboratory performance in diagnostic and typing methodologies.
- To create a common European database for identification and verification of new and existing genetically defined clones of the causative organism Corynebacterium diphtheriae that have the potential to cause epidemics.

In 1988, there were just less than 30.000 reportea cases or alpnrnena worluwloe. In 1995 more than 50.000 cases were reported from the European Region alone. The largest diphtheria 'epidemic' since the 1960 is in progress in Eastern Europe, which poses an immense threat to all countries within the EU. Increasing international travel, migration from Eastern Europe and the emergence of epidemic strains of Corynebacterium diphtheriae highlight the urgency for better microbiological surveillance and greater clinician and laboratory awareness. International collaboration between established diphtheria reference centres and the formation of new centres within Europe is essential to improve laboratory diagnosis, monitor the spread of the disease and the pathogenicity of C.diphtheriae. The establishment of a European network within the member states will provide the basis for the exchange of information on the current epidemics of diphtheria. Further, the creation of a common database for the identification and verification of new and existing strains that have the potential to cause epidemics is crucial if we are to eliminate this newly resurgent infectious disease from Europe.

The proposal aims to provide improvements to, standardisation and harmonisation of, methodologies for the laboratory diagnosis of the disease and epidemiological typing of the causative organism. Also, to strengthen international collaboration and laboratory based surveillance between newly established and existing diphtheria reference centres in Europe.

This will be achieved by:
i) the formation of a network of Diphtheria Reference Centres within Europe;
ii) the establishment of a core set of clinical and epidemiological data items ('passport') to accompany, where possible each laboratory confirmed case of diphtheria in Europe;
iii) the improvement of laboratory based surveillance and information exchange to bring any potential 'clusters' within a particular area to the attention of the participants and relevant public health officials; and to identify any potentially pathogenic 'clones' that may be circulating;
iv) the standardisation and dissemination of public health methodologies and protocols for microbiological surveillance in order to improve the effectiveness of EU wide prevention of this disease;
v) introduction of a European international quality assurance scheme for laboratory performance in diagnostic and typing methodologies;
v) the creation of an international database of genotyping patterns as determined by molecular methods and the monitoring of the distribution of these genotypes within Europe.

These objectives once initiated and achieved should enhance and increase clinical and microbiological awareness and through concerted action curtail the present resurgence of this potentially fatal infectious disease within Europe.

Keywords: Diphtheria, Corynebacterium diphrheriae, Infectious Diseases, Network, Epidemiological typing, Surveillance, Quality Assurance.

Funding Scheme

CON - Coordination of research actions

Coordinator

PUBLIC HEALTH LABORATORY SERVICE
Address
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United Kingdom