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Volume 24, Number 7—July 2018
Dispatch

Diphtheria Outbreak in Amerindian Communities, Wonken, Venezuela, 2016–2017

Adriana Lodeiro-Colatosti, Udo Reischl, Thomas Holzmann, Carlos E. Hernández-Pereira, Alejandro Rísquez, and Alberto E. Paniz-MondolfiComments to Author 
Author affiliations: Instituto de Salud Pública del Estado Bolívar, Bolívar, Venezuela (A. Lodeiro-Colatosti); Infectious Diseases Research Incubator, Barquisimeto, Venezuela (A. Lodeiro-Colatosti, C.E. Hernández-Pereira); Zoonosis and Emerging Pathogens Regional Collaborative Network, Barquisimeto (A. Lodeiro-Colatosti, C.E. Hernández-Pereira); University Hospital of Regensburg, Regensburg, Germany (U. Reischl, T. Holzmann); Universidad Centroccidental Lisandro Alvarado, Barquisimeto (C.E. Hernández-Pereira); Universidad Central de Venezuela, Caracas, Venezuela (A. Rísquez); Instituto de Investigaciones Biomédicas IDB, Cabudare, Venezuela (A.E. Paniz-Mondolfi); Instituto Venezolano de los Seguros Sociales, Caracas (A.E. Paniz-Mondolfi)

Main Article

Table

Demographics and clinical characteristics of 10 Amerindians with suspected diphtheria cases, Wonken, Venezuela, 2017*

Case-patient no. Age, y/sex Location† Signs and symptoms Duration Treatment Outcome
1 31/M, returning miner Urimpatá Hyperthermia; dysphagia; odynophagia; dysphonia; gray adherent membranes; massive cervical lymphadenopathy 9 d Azithromycin (500 mg, 2×/d for 10 d), 7-d cycle ampicillin/sulbactam, penicillin G benzathine (1.2 million units, IM, 1 dose), adult Td to contacts Survived
2 4/F, household contact of case-patient 1 Urimpatá Dysphagia; odynophagia; hemoptysis; fever; gray adherent membrane formation; cervical lymphadenopathy 7 d Azithromycin (10 mg/kg,1×/d for 7 d), cefotaxime/clarithromycin at admission, Tdap vaccination Survived, admitted to reference hospital
3 9/F, household contact of case-patient 1 Urimpatá Abrupt onset of odynophagia; barking cough; dysphonia; stridor and gray adherent pseudomembranes covering tonsils, uvula, and pharynx 7 d Azithromycin (10 mg/kg, 1×/d, 7 d), penicillin G benzathine (0.6 million units, IM, 1 dose), Tdap vaccination Survived
4 14/F Atanao Fever; dysphonia; dysphagia; odynophagia ≈1 wk No data Died
5 4/M Atanao Dysphagia; odynophagia; dysphonia; hyporexia ≈1 wk No data Died
6 9/F Urimpatá Odynophagia; barking cough; dysphonia; stridor and gray pseudomembrane covering tonsils, uvula, and pharynx ≈1 wk Azithromycin (10 mg/kg, 1×/d, 7 d), penicillin G benzathine (0.6 million units, IM, 1 dose), Tdap vaccination Survived
7 9/F Damasko Dysphagia; odynophagia; dysphonia; fever; gray pseudomembrane covering tonsils, uvula, and pharynx ≈1 wk Azithromycin (10 mg/kg, 1×/d for 7 d), penicillin G benzathine (0.6 million units, IM, 1 dose), Tdap vaccination Survived
8 13/F Damasko Odynophagia; fever; small grayish membranes admixed with vesicles covering pharynx ≈1 wk Azithromycin (10 mg/kg, 1×/d for 7 d), penicillin G benzathine (0.6 million units, IM, 1 dose), Tdap vaccination Survived
9 Unknown Atanao, in transit to Vista Alegre community Reported as signs and symptoms suggestive of diphtheria Unknown No data Unknown
10 Unknown Atanao, in transit to Vista Alegre community Reported as signs and symptoms suggestive of diphtheria Unknown No data Unknown

*None of the case-patients were previously immunized or received diphtheria antitoxin as treatment. No case-patients had cutaneous or neurologic signs or symptoms. IM, intramuscular; Td, tetanus-diphtheria; Tdap, tetanus-diphtheria-acellular pertussis.
†Location coordinates: Urimpatá (5.128429°N, −61.380956°E); Atanao (5.128429°N, −61.380956°E); and Damasko (5.127997°N, −61.504152°E).

Main Article

Page created: June 18, 2018
Page updated: June 18, 2018
Page reviewed: June 18, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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