Algeria - Outbreak of diphtheria reported in Tamanrasset

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Map of Algeria highlighting Tamanrasset
/https://en.wikipedia.org/wiki/Tamanrasset_Province

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Translation Google

An outbreak of diphtheria recorded in Tamanrasset: Twenty cases among foreign children not attending school

07/15/2023 updated: 16:05
Salima Tlemcani

The discovery of an outbreak of diphtheria, in Tamanrasset, among foreign children from neighboring countries, is causing great concern among health professionals in the region, especially since the information spread like wildfire this week.

More than twenty suspected cases have been recorded in the town of Tamanrasset and in that of Tin Zaouatine, on the Algerian-Malian border, of which at least 11 have been confirmed by the Pasteur Institute, during the past week. This respiratory infection is very dangerous, as it attacks the central nervous system, throat and other organs and can even lead to death by asphyxiation. It is caused by a bacterium producing a toxin, which is transmitted (from 2 to 5 days of incubation) through nasopharyngeal secretions or skin wounds and very rarely by objects soiled by secretions from patients. All cases recorded to date are unvaccinated children.

No awareness campaign on this contagious, notifiable infection, which is currently limited to only two regions, has been launched. All our steps with the local health authorities have not been successful.

The Ministry of Health, for its part, has not yet reacted to anticipate a probable spread through protective and preventive measures against this dangerous disease, especially since due to the hot season, a large flow of families from northern Mali and Niger move to Tamanrasset, where the climate is milder at this time of year.

At the start of this year, it should be remembered, Niger declared to international health authorities 281 cases of diphtheria and 19 deaths. In northern Mali and during the same period, strong rumors about numerous cases of this infection circulated and persisted, but due to the security situation, no official investigation was made.

In Algeria, it should be remembered, vaccination against diphtheria (along with that against tetanus) is compulsory. In newborns, it is done in two stages. The first at 2 months, the second at 4 months, before the recall at 11 months. After the age of 18, and every ten years, another vaccination is also compulsory.

https://elwatan-dz.com/un-foyer-de-diphterie-enregistre-a-tamanrasset-une-vingtaine-de-cas-parmi-des-enfants-etrangers-non-scolarises

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Dr Elias Akhamouk. Head of the infectious diseases department at the EPH in Tamanrasset: "Diphtheria is contained, but the health threats are there"

08/08/2023 updated: 16:28
Salima Tlemcani

Doctor Elias Akhamouk returns in this interview to the health situation in Tamanrasset, the gateway to tropical diseases, the working conditions in the hospital, of which two thirds of the patients he takes care of are migrants. He also speaks about the cases of diphtheria recorded at the level
of the wilaya.

Interview conducted by Salima Tlemçani

-Nearly 80 cases of diphtheria have been recorded, including 16 confirmed by the Institut Pasteur (IPA), and more than ten deaths. We are therefore facing a hotbed of contamination. How did we get to this situation?

This is one of the health consequences of the clandestine migration of a large section of an unvaccinated population. Almost all hospitalized patients are foreigners, never educated, therefore not vaccinated. This makes them vulnerable to all infections. Fortunately, in Algeria, the diphtheria vaccination rate is very high. It is estimated at more than 90%.

A rate considered very high. This explains the non-spread of the epidemic among Algerians. Germany, for example, experienced the same situation in 2022 with more than 130 cases of diphtheria affecting migrants, but without consequences for the locals, who are protected by vaccines. The same thing in Great Britain which recorded 50 cases of diphtheria among migrants, but without affecting the local population.

-Has this outbreak been circumscribed and by what means?

The outbreak was circumscribed thanks to the work of the crisis unit chaired by the DSP with epidemiological investigations to detect cases in the entourage of patients and to take care of them. Each of these patients is isolated. We take his contact details and especially his address to dispatch a team on site to track and vaccinate contact cases. Since these are generally communities, vaccination is extended to all members of them. Occasionally, mass vaccination is organized in neighborhoods where affected communities of foreigners mainly reside.

What is important and positive is the fact that everyone is seeking to be vaccinated. The most affected neighborhoods are generally known. They are on the outskirts of the city of Tamanrasset and vaccination in these places is done en masse. I must emphasize the training of general practitioners, which remains very important, because to date, I am the only infectious disease specialist who detects and isolates all suspected cases in Tamanrasset.

-Diphtheria is known as a notifiable infection, how is it that there is no awareness campaign on this epidemiological focus?

We alerted the health authorities from the start of the epidemic, because it is indeed a notifiable disease and also a public health emergency. There is even a team that traveled from Algiers and we sent them our needs directly. First in medical specialists, then in budgets, drugs and equipment.

- Can we say that the epidemic has been contained?

I must say that the epidemic has been brought under control, but we must remain vigilant.

-For what ?

Because there are simple cases that do not go through the hospital and can go unnoticed. There are also healthy carriers who are non-ill people carrying diphtheria bacteria in the throat and who can infect others as is the case for Covid-19. In addition, every day, families of migrants cross the border and arrive in Tamanrasset, which increases the risk of the arrival of contaminated cases. So the diphtheria epidemic may be contained but the health threats are still there.

-What do you mean ?

There are typical tropical diseases such as malaria or Marburg and Ebola or even mycetoma, but also re-emerging diseases such as diphtheria, measles, polio and even leprosy which can arrive at our borders due to the movement of populations.

-All these diseases which are likely to arrive easily at our borders can be diagnosed, but are we threatened by others which we cannot diagnose due to lack of resources or knowledge?

Of course, because tropical diseases also require qualified personnel, isolation structures with international standards, but above all a laboratory equipped to carry out the diagnosis on site, because we cannot afford to wait for the results that we arrive from Algiers.

- Is this the case today?

For some diseases, this is the case. As for diphtheria, for example, of which 16 cases have been confirmed by the Pasteur Institute in Algiers, we are not obliged to diagnose all suspected patients.
This disease is relatively clinically recognizable. But, for many other tropical diseases, the confirmation must necessarily be biological. This requires specific laboratories, adequate equipment and qualified personnel. It is therefore necessary to ensure that this device is available to deal with any health threat.

- Being the only infectiologist at EPH Tamanrasset, under what conditions do you work?

I cannot hide the fact that the working conditions at the Tamanrasset hospital are difficult. It is the only hospital that covers three wilayas, namely Tamanrasset, In Guezzam and Bordj Badji Mokhtar. And since Tamanrasset is the first migration and even settlement platform for migrants. More than a third of our patients, all specialties combined, are migrants.

This adds a considerable additional burden for the infectious diseases department which deals with the usual infectious pathologies, tropical diseases such as malaria with more than a thousand cases each year.

We must also not forget that the Tamanrasset hospital is an HIV/AIDS reference centre, the only one that exists in the Far South. And with the departure of infectious disease specialists, I would say that human reinforcement has become an emergency. Currently, we are only two infectiologists, responsible for all activities.

https://elwatan-dz.com/dr-elias-akhamouk-chef-du-service-des-maladies-infectieuses-a-leph-de-tamanrasset-la-diphterie-est-endiguee-mais-les-menaces-sanitaires-sont-la


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Should we worry about the appearance of several cases of diphtheria in Algeria?

It was believed to be eradicated. However, diphtheria, a serious highly contagious disease, has just been detected on Algerian soil.

Badr Kidiss
Written on 08/16/2023

It resurfaces. Diphtheria, a contagious and potentially fatal bacterial infection, has been reported in various wilayas in southern Algeria. At the time of writing, 80 cases have been identified, including 16 confirmed cases. Of all the cases recorded, "most are foreign nationals from unvaccinated neighboring countries who live in the suburbs of the city of Tamanrasset" , specifies the Ministry of Health.

However, Algeria has been witnessing a worrying increase in the number of diphtheria cases for several years. Sporadic cases were reported in 2019, while 30 confirmed cases were recorded between 2020 and 2022. A period that coincided with the Covid-19 pandemic and vaccine delays . In Algeria and elsewhere in Africa, many children have not received the injections provided for in their vaccination schedule. This could explain the resurgence of diphtheria, a disease preventable by vaccination.

The Ministry of Health responds

Faced with this situation, the Ministry of Health assures, in a press release, that "all measures have been taken urgently by the local health authorities to prevent the spread of diphtheria" . He cites the " care of all cases at the level of health structures, the creation of a crisis cell to monitor the epidemiological situation and strengthen surveillance and the carrying out of investigations into cases" .

The health authorities ensure that " all the means (drugs, anti-diphtheria serum, vaccines, sampling equipment, etc.) have been made available to the care or vaccination teams" in the regions where cases of diphtheria have been detected. . Also in this press release, the Ministry of Health assures that “more than 10,100 people” were vaccinated during the vaccination campaign launched “as soon as this disease appeared”.

https://www.allodocteurs.africa/faut-il-sinquieter-de-lapparition-de-plusieurs-cas-de-diphterie-en-algerie-8184.html