National Reference Center (NRC) for Toxigenic corynebacteria

General information

Use and availability of diphtheria antitoxin

The diphtheria antitoxin is available in Belgium, after contacting the health inspector of your region. 

General information

In the 20 years of activity as a reference laboratory, no toxinogenic C. diphtheriae strain has been isolated. The Walloon Health Inspectorate once reported 3 cases in the 1990s, which were never officially reported. The diagnosis would have been made in a German laboratory. It involved an imported case from Russia and 2 secondary cases.

Our country has a high vaccination coverage, reinforced by replacing the tetanus vaccine (T) with a combined Td vaccine for tetanus vaccination of adults. The real protection of the population is not known, as no seroepidemiological studies have been carried out with reference techniques.

Nevertheless, the infection can spread rapidly in the unvaccinated population, as it did in the former USSR countries from 1990 to 1997. Smaller outbreaks occurred in Ecuador (1993-1994) and Algeria (1993-95). Such outbreaks can then be the source of import cases and secondary cases in countries with better vaccination coverage, where adults lack protective antibodies.

In the years 2000-2009, the highest endemic incidence in Europe was found in Latvia, with lower incidences in Georgia, Ukraine and Russia.

Some strains of C. ulcerans (and very rarely C. pseudotuberculosis) can produce diphtheria toxin. The disease can then present itself as a clinical diphtheria. Such infections should be treated as diphtheria. But interhuman transmission of these microorganisms is very rare. The infection is usually acquired through contact with raw milk and contact with farm and farm animals. Cases have also been described following close contact with companion animals.

Responsible laboratories



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