Thanks to good vaccination rates, Latvia had been able to maintain a nearly diphtheria-free zone for years. Between 2009 and 2023, 122 cases of the deadly disease were recorded, ten of which proved fatal.
Unfortunately, Latvia has unvaccinated children and adults, so a localized outbreak of diphtheria started last week. Doctors at the Children's Hospital are urging you to check that all family members have been vaccinated and received all boosters. If not, this should be done immediately. If the first symptoms of the disease appear, immediate medical attention should be sought, and isolation and testing are mandatory for all contacts.
All four children admitted to Children's Hospital last week were not vaccinated. It is not yet possible to say how serious the consequences of the disease will be for their health and future lives if they survive.
"With the increase in the proportion of unvaccinated people, both among children after the pandemic when they did not receive the vaccine at all due to different parental beliefs, and among adults when they forgot or decided not to receive the state-paid vaccination after 10 years, the number of people susceptible to dangerous infections has also increased in our country and diphtheria is back.
"The infectious agents may have been introduced by travelers from other countries or have been circulating in Latvia, but last week they unfortunately met unvaccinated people. However, the sick children were already taken to kindergarten and school with the first symptoms, so there is a high risk that the infection has spread and that more people will become ill," explains Dace Zavadska, Head of the Family Vaccination Center at the Children's Hospital.
The Disease Prevention and Control Center (SPKC), after receiving information about a confirmed case of diphtheria last week, immediately launched an epidemiological investigation and the organization of the necessary anti-epidemic measures - identification of contacts, laboratory testing, and medical surveillance. Three children and one adult have now been diagnosed with diphtheria.
All cases are linked to each other and are from the Vidzeme region.
Epidemiological investigations and antipidemic measures are ongoing, SPKC said.
"Many doctors really haven't seen what the symptoms of diphtheria look like in real life, so now everyone needs to remember that it can be diphtheria. Parents should know that difficulty swallowing and breathing may be the first symptoms of the disease.
"If the symptoms are not so acute at first and the child is not taken to the doctor within the first three days, even with high doses of diphtheria-specific immunoglobulin, their life may be at risk. It is for a reason that it is called a deadly infection.
"Diphtheria can also have severe and lasting effects on the central nervous system, kidneys, and cardiovascular system. In those who have been vaccinated and exposed to the infectious agent, the disease may start in some cases, but it is mild and without complications. However, at the beginning of the disease, all those who are ill are carriers," says Gunta Laizāne, chief doctor of the Children's Hospital's Infectious Disease clinic.
What is diphtheria?
The source of diphtheria infection can be both a person with diphtheria and a healthy person who does not suffer from diphtheria but is a carrier of the diphtheria bacterium.
Most often, diphtheria enters the human body through the tonsils, throat, and nasal mucosa. Diphtheria can be contracted by inhaling air containing microscopic droplets of the bacteria, which are spread by talking, coughing or sneezing by a diphtheria sufferer or a carrier of the bacterium. The infection also has a cutaneous form, when a person becomes infected through a wound.
The incubation period of the disease is from 2 to 5 days, but in some cases, it can be even up to 10 days. Sometimes, at the beginning of the disease, a slightly increased body temperature, weakness, and sweating can be observed. These symptoms gradually progress, and the characteristic signs of diphtheria develop:
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general weakness;
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temperature rise;
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sore throat, redness, swelling, difficulty swallowing;
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a gray plaque appears on the tonsils, which can spread throughout the throat.
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in small children, plaque can start from the larynx, in this case cough, hoarseness and difficulty breathing occur;
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headache and loss of appetite are also possible.
If a person shows any signs characteristic of diphtheria, he or she should be immediately hospitalized, isolated and specific treatment should be started. If you notice signs of diphtheria, contact your family doctor immediately.
More information: https://www.spkc.gov.lv/lv/difterija