Announcement

**Pathfinder** · September 5, 2023, 09:31 AM

Translation Google

Health: the diphtheria epidemic kills 37 in the Kankan region

Posted By: Mohamed Moro Sacko On: Friday, September 01, 2023 At 12:12 P.M.

The disease called diphtheria is ravaging the Kankan region, Guineanews has learned. However, at the level of the Regional Health Directorate, there is radio silence.

Indeed, since July 2023, diphtheria, an infectious disease caused by the bacterium Corynebacterium diphtheriae, has been claiming victims in Upper Guinea, particularly in the Kankan region.

Currently, 37 cases of death have been recorded, all children between 0 and 7 years old, according to the World Health Organization.

According to the explanations of Jean Traoré, Head of Communication and Media Unit of the ANSS at the microphone of our colleagues from UNIVERSCIENCES, the patients are brought to the Kankan regional hospital for treatment.

“Our teams are on the ground to carry out investigations in order to find out the causes and the modes of spread of the disease. I specify that it is the zones of Siguiri, Mandiana which are more concerned. At the moment, 212 people are being monitored in these three prefectures,” he said.

Reached by our local editorial staff, the Kankan Regional Health Department does not want to communicate on this situation, because a WHO mission is announced in the days that follow.

The catch is that diphtheria is a serious disease that is spreading through the region with its corollary victims.

People with diphtheria may develop fever, fatigue, and weakness. General symptoms of malaise, fatigue and weakness may be present. If left untreated, the toxins produced by the bacteria can lead to serious complications, such as heart and nerve problems.

Diphtheria is usually spread by airborne droplets from an infected person's cough or sneeze.

In the meantime, no official communication has been made by the Guinean health structures to allow the communities to understand what is happening.

Santé : l’épidémie de la diphtérie fait 37 morts dans la région de Kankan

https://guineenews.org/sante-lepidemie-de-la-diphterie-fait-37-morts-dans-la-region-de-kankan/

La maladie appelée diphtérie fait des ravages dans la région de Kankan, a appris Guinéenews. Cependant, au niveau de la Direction régionale de la santé, c'est le silence radio. En effet, depuis le mois de juillet 2023, la diphtérie une maladie infectieuse causée par la bactérie Corynebacterium diphtheriae, est en train de faire des victimes [...]

**Pathfinder** · September 5, 2023, 09:41 AM

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 34: 21 - 27 August 2023
Data as reported by: 17:00; 27 August 2023

...

Guinea

Diphtheria

117 Cases
37 Deaths
31.6 % CFR

EVENT DESCRIPTION

Suspected case of diphtheria have been reported in
Kankan region of Guinea since 4 July 2023. Laboratory
confirmation was obtained on 20 July. During week 34
(ending 27 August), 18 suspected cases, including
seven deaths, were reported from two Districts; Siguiri
(17 cases) and Mandina (1 case).

From the beginning of the outbreak on 4 July to 27
August, a total of 117 suspected cases were reported,
including seven confirmed cases. In total, 37 deaths
have been reported, including all confirmed cases. Nine
(24.3%) deaths occurred in the community. At present,
189 active contacts are under followed up.

Siguiri District is the most affected with 100 cases
(85.5%). The other Districts reporting cases are Kankan
(8 cases), Mandiana (7 cases) and Kouroussa (2 cases).
Only the Kérouané District in the Kankan region did not
report any cases.

Of the reported cases, 69(59%) are female. The age
group 1-4 years is the most affected with 60 cases
(51.3%), followed by the age groups 5-9 years and 10+
years with 26 cases each (22.2%) and the age group
under 1 year with five cases (4.3%). Of the 64 patients
who were admitted to treatment centers, 28 (43.8%)
died.

PUBLIC HEALTH ACTIONS

• The Regional Coordination Unit is managing response
activities and holds daily meetings.

• Surveillance activities have been heightened in
the affected Districts to reinforce case detection and
reporting at facility and community levels, as well as the
conduct of in-depth case investigations for new clusters
of cases.

• Case management activities are ongoing at health
facilities in the Districts. This is a free service for all
Diphtheria related cases.

• Risk communication activities have been scaled up in
the affected areas. Community engagement activities,
are ongoing to create awareness in the affected areas.

• Other response measures include laboratory diagnosis,
and prepositioning of essential medical supplies

SITUATION INTERPRETATION

According to WHO and UNICEF estimates of national
immunization coverage, routine immunization coverage
for the third dose of pentavalent vaccine (which includes
diphtheria vaccine) was 47% in Guinea in 2022, and even
lower in the Kankan region according to a recent survey.
This low coverage, combined with other factors, could
facilitate the spread of the outbreak. Given the high case
fatality rate, surveillance should be strengthened to detect
additional cases early, and case management should be
improved to save more lives.

403 Forbidden

https://apps.who.int/iris/bitstream/handle/10665/372811/OEW34-2127082023.pdf

**Pathfinder** · September 29, 2023, 08:44 AM

Translation Google

Kankan: diphtheria epidemic kills 54 people

BY ABDOUL MALICK DIALLO September 27, 2023 at 4:00 p.m.

Reported on July 20, 2023, in Siguiri, in the Kankan health region, the diphtheria epidemic reached the prefectures of Mandiana, Kouroussa and Kankan.

To date, health authorities in the region have deplored 54 deaths, distributed as follows: 42 in Siguiri, 11 in Kankan and 1 in Kouroussa (sitRep 36). As well as 255 suspected cases counted and all contacts are followed. To date, 62 people are under treatment in the Kankan and Siguiri treatment centers.

The ongoing epidemic in the Kankan health region has mainly affected children under 12 years old and girls represent almost 60% of this affected age group.

“In addition to patient care, vaccination of contacts is also one of the response actions undertaken by the Ministry of Health through its technical services in collaboration with partners. 9,415 people are already vaccinated among contacts. Actions are continuing and a regional response plan is being developed and submitted to the authorities for funding with a view to rapid control of the epidemic,” explained Sory 2 Keira, head of the risk communication, social mobilization and community engagement department. to the National Health Security Agency (ANSS).

An infectious respiratory disease, diphtheria causes damage to the central nervous system, throat or other organs leading to death by asphyxiation.

Kankan: l’épidémie de la diphtérie fait 54 décès

https://www.guinee360.com/27/09/2023/kankan-lepidemie-de-la-diphterie-fait-54-deces/

Signalée, le 20 juillet 2023, à Siguiri, dans la région sanitaire de Kankan, l'épidémie de la diphtérie a atteint les

**Shiloh** · October 18, 2023, 04:11 PM

Source: https://www.who.int/emergencies/dise...em/2023-DON492

Diphtheria - Guinea
18 October 2023

Situation at a Glance

On 5 September 2023, the Ministry of Health notified WHO of a diphtheria outbreak in Guinea. From 4 July to 13 October 2023, a total of 538 cases of diphtheria, were reported in the Kankan region, in the east-central part of Guinea. Of the total cases reported, 520 are suspected and 18 confirmed with 58 deaths including 13 among confirmed cases (case fatality rate (CFR) among all cases, 11%). The 1-4 years age group accounted for the largest proportion of reported cases. Diphtheria is a highly contagious vaccine-preventable disease caused mainly by the bacteria Corynebacterium diphtheriae which can be fatal in 5-10% of cases, with a higher mortality rate in young children. However, in settings with poor access to diphtheria antitoxin, the CFR can be as high as 40%. Diphtheria remains a significant health problem in countries with poor routine vaccination coverage. According to WHO/UNICEF estimates of national immunization coverage (WUENIC), the immunization coverage with the diphtheria tetanus toxoid and pertussis (DTP3) containing vaccine was reported to be 47% for 2022 in Guinea and has remained below 50% since 2014. This is insufficient for achieving the coverage of 80–85% required to maintain community protection. WHO assesses the risk of diphtheria to be high in Guinea, considering the chronically low vaccination coverage.
Description of the Situation

On 5 September 2023, the Ministry of Health notified WHO of the current diphtheria outbreak in Guinea. On 4 July 2023, two children aged 2 and 4 years, attended the otolaryngology department of the Siguiri prefectural hospital in the Kankan region of Guinea, for similar symptoms (dyspnea, dysphasia, fever, cough). They were hospitalized for tonsillitis and respiratory infection and received antibiotic treatment before being referred to the Kankan regional hospital for additional care.
Since 4 July and as of 13 October 2023, 538 cases have been reported, including 18 confirmed cases. In total, 58 deaths including 13 among confirmed cases were registered (case fatality rate (CFR) among all cases, 11%)., and 461 contacts are being followed up. Of the cases reported, 62% are female. The 1-4 years age group, with 445 cases, accounted for the largest proportion of reported cases, 82%, followed by the 5-9 years age group, with 5% and 5% for the 10 years and above age group. Children under the age of 12 months make up 7% of reported cases. None of the 538 cases were vaccinated.
Kankan Region is divided into five prefectures and only the Kérouané prefecture has not reported any cases to date.
The prefecture of Siguiri is the most affected, with 510 cases (95%). Of the 363 patients admitted to the treatment centers in Siguiri, 37 (10%) have died.
Other prefectures reporting cases are Mandiana (13 cases), Kankan (13 cases) and Kouroussa (two cases). Of the 15 patients admitted in the treatment center in Kankan, 12 (80%) have died.
The treatment centers in the country do not have the capacity in terms of human resources and material for adequate case management. Suspected and confirmed cases were treated with Amoxicillin and Azithromycin as first line therapy. Antibiotic prophylaxis (Amoxicillin, Azithromycin) was administered to the direct contacts.
Figure 1: Distribution of diphtheria cases in Kankan region, Guinea, as of 13 October 2023

Figure 2: Suspected diphtheria cases by epidemiological week in Guinea, as of 13 October 2023

Epidemiology

Diphtheria is a highly contagious vaccine-preventable disease caused mainly by Corynebacterium diphtheria but also byCorynebacterium ulcerans. It spreads between people mainly by direct contact or through the air via respiratory droplets. The disease can affect all age groups; however, unimmunized children are most at risk.
Symptoms often come on gradually, beginning with a sore throat and fever. In severe cases, the bacteria produce a poison (toxin) that causes a thick grey or white patch at the back of throat. This can block the airways, making it hard to breathe or swallow, and also creates a barking cough. The neck may swell in part due to enlarged lymph nodes.
Treatment involves administering diphtheria antitoxin (DAT) as well as antibiotics. Vaccination against diphtheria has been effective in reducing the mortality and morbidity from diphtheria dramatically. Diphtheria is fatal in 5-10% of cases, with a higher mortality rate in young children. However, in settings with poor access to DAT, the CFR can be as high as 40%.

Public Health Response

Guinea has strengthened epidemiological surveillance for early detection and case management.
Daily coordination and monitoring meetings on the response activities are underway at the Regional level, led by the regional health inspector and with the support of WHO, MSF- Belgium and other partners in the region.
Notification of all suspected cases of diphtheria, investigation initiation, and monitoring of contacts as soon as possible has been enhanced.
Contact tracing, identification of an isolation zone at the Balato health post in the prefecture of Kouroussa and briefing of the healthcare workers on the case definition and prevention measures are ongoing.
Case management activities such as antibiotic therapy (Amoxicillin, Azithromycin), treatment of suspected cases, antibiotic prophylaxis (Amoxicillin, Azithromycin) for the direct contacts and free case management at treatment centers with support from MSF are provided.
Risk communication and community engagement efforts, such as raising awareness of cases in the community and identifying and briefing a communicator to raise awareness among parents of patients is ongoing.

WHO Risk Assessment

Diphtheria is a vaccine-preventable disease caused by exotoxin-producing Corynebacterium diphtheriae, transmitted from person to person through close physical and respiratory contact. It can cause infection of the nasopharynx, which may lead to breathing difficulties and death. Diphtheria is fatal in 5 - 10% of cases, with a higher mortality rate in young children. Treatment involves administering diphtheria antitoxin as well as antibiotics. Vaccination against diphtheria has reduced the mortality and morbidity of diphtheria dramatically.
The DAT supply is currently very constrained and insufficient to respond to current demands, as there is only a limited number of manufacturers and large outbreaks are being reported in different regions of the world.
The risk of diphtheria in Guinea is considered high due to the low DTP3 vaccination coverage in the affected region (36% according to the survey coverage in households, 2023) and 47% national DTP3 vaccination coverage between 2014-2022 (per WHO/UNICEF estimates), and the risk at the regional level is moderate and low at the global level. The outbreak is also characterized by high case fatality among confirmed cases. Other factors include: the over population of the Siguiri health district, which is the epicenter of this outbreak, the weakened healthcare system and several concurrent epidemics in the area.
The overpopulation of the Siguiri health prefecture, the epicenter of this epidemic, the insufficient poorly qualified health personnel, and the limited material resources of the health system weakens the response to this outbreak. In addition, the country is facing several concurrent epidemics in the area, such as pertussis, poliomyelitis, and rabies. Adding this to a context of extreme vulnerability due to mining activities, which induce significant population movement, reduce air quality, and increase the risk of natural disasters such as floods and landslides, impacting people’s health.
This emphasizes the urgent need to strengthen diphtheria vaccination coverage nationwide, especially in the epicenter and strengthen case management at hospital facilities dealing with diphtheria cases.

WHO Advice

The control of diphtheria is based on primary disease prevention by ensuring high population immunity through vaccination and secondary prevention of spread by the rapid investigation of close contacts to ensure prompt treatment of those infected.
Epidemiological surveillance ensuring early detection of diphtheria outbreaks should be in place in all countries, and all countries should have access to laboratory facilities for reliable identification of toxigenic C. diphtheriae. Adequate quantities of diphtheria antitoxin should be available nationally or regionally for the medical management of cases.
Vaccination is vital to preventing cases and outbreaks, and adequate clinical management involves administering diphtheria anti-toxin to neutralize the toxin and antibiotics reducing complications and mortality.
WHO recommends early reporting and case management of suspected diphtheria cases to initiate the timely treatment of cases and follow-up of contacts and ensure the supply of diphtheria antitoxin.
WHO advises implementing the following Infection Prevention & Control (IPC) measures in health care settings:
At screening/triage, immediately place patients with symptoms of Upper Respiratory Tract Infection (URTI) in a separate area until examined, and, if a probable case, cohorted with patients with the same diagnosis. Keep the isolation area segregated from other patient-care areas.
In addition to using standard precautions, patients with known or suspected respiratory diphtheria are placed under droplet precautions. Patients with known or suspected cutaneous diphtheria should be placed under contact precautions. Maintain one meter between patients. Keep patient care areas well- ventilated. Avoid patient movement or transport out of the isolation area. If movement is necessary out of the isolation area, have the patient use a medical mask and cover any wounds/lesions on the patient’s body.
Case management should be carried out following the WHO guidelines. In addition, high-risk populations such as young children under five years of age, school children, the elderly, close contact with diphtheria cases, and healthcare workers should be vaccinated on a priority basis. A coordinated response and community engagement can support further transmission and control of the ongoing outbreak.
Prophylactic antibiotics (penicillin or erythromycin, dependent on the isolate antibiotic sensitivity) are indicated for close contacts for seven days. If the culture is positive for toxigenic Corynebacterium spp.., the contact should be treated as a case with an antibiotic course for two weeks (DAT is not needed for asymptomatic cases or cases without a pseudo membrane).
Although travelers do not have a particular risk of diphtheria infection, it is recommended that national authorities remind travelers going to areas with diphtheria outbreaks to be appropriately vaccinated in accordance with the national vaccination scheme established in each country before travel. A booster dose is recommended if more than five years have passed since their last dose.
WHO does not recommend that any general travel or trade restrictions be applied to Guinea based on the information available for this event.

Further Information

WHO diphtheria page: https://www.who.int/teams/health-pro...ion/diphtheria
Manual for quality control of diphtheria, tetanus, pertussis and combined vaccines: https://www.who.int/publications-det...WHO-IVB-11.-11
Diphtheria: Vaccine Preventable Diseases Surveillance Standards: https://www.who.int/publications/m/i...rds-diphtheria
Transmission-based precautions for the prevention and control of infections: aide-memoire: https://www.who.int/publications/i/i...IHS-IPC-2022.2
WHO. Diphtheria: Clinical management of respiratory diphtheria: https://openwho.org/courses/diphther...cal-management

Citable reference: World Health Organization (18 October 2023). Disease Outbreak News; Diphtheria in Guinea. Available at: https://www.who.int/emergencies/dise...em/2023-DON492

**Pathfinder** · November 1, 2023, 10:25 AM

Translation Google

Guinea in the grip of a serious diphtheria epidemic while the country lacks health personnel

According to the WHO, at least 62 infected people have died since the outbreak of the epidemic in July in the Upper Guinea region (East). This highly contagious disease, mainly affects early childhood, attacks the respiratory tract and causes death by asphyxiation.

Published on :01/11/2023 - 10:37
Modified :01/11/2023 - 11:43

By : RFI

The Ministry of Health alerted the World Health Organization ( WHO ) last September about the diphtheria outbreak in the Kankan region, the epicenter being in the gold mining town of Siguiri, near the Malian border. When the disease appeared four months ago, mortality stood at 36%. This rate was divided by three after the treatment protocol put in place with the National Health Security Authority of Guinea and the NGO Médecins sans frontières (MSF).

According to the UN health organization , the spread of the diphtheria epidemic comes from the low vaccination coverage which concerns less than half of the territory since 2014. To blame, vaccines out of stock, non-compliance with the cold chain and the significant lack of health personnel.

“ Classes opened, and children who were on vacation from one region to another began to mix. So they had plenty of time to transmit the disease during the infectious period at school level , explains Dr Seydou Dia, WHO emergency manager in Guinea. We had admissions at the level of three to four cases per day, now we are at almost ten cases per day, and today MSF is wondering if we can have containers to transform their offices into places of hospitalization. So this is a situation that is developing unfavorably. »

The WHO states that several countries in the sub-region are affected by the diphtheria epidemic. A possible consequence of the fight against the Covid-19 pandemic, which had been prioritized to the detriment of other diseases.

https://www.rfi.fr/fr/afrique/20231101-la-guin%C3%A9e-en-proie-%C3%A0-une-grave-%C3%A9pid%C3%A9mie-de-dipht%C3%A9rie-alors-que-le-pays-manque-de-personnel-de-sant%C3%A9

**Pathfinder** · January 27, 2024, 10:25 AM

Why diphtheria is making a comeback

JANUARY 23, 20247:30 AM ET
By Simar Bajaj

It had been over 30 years since the last case of diphtheria was seen in Guinea. So when patients began showing up six months ago with what looked like flu symptoms — fever, cough and sore throat – doctors weren't alarmed. Until the children started dying.
...
Guinea was particularly vulnerable because of its low diphtheria vaccination rate – only 47% in 2022, with the hardest-hit Siguiri prefecture having even lower coverage at 36%.
...
In Guinea, Doctors Without Borders says its staff has supported local health workers in addressing diphtheria. Together, they've reduced mortality at Siguiri's Center for the Treatment of Epidemics from 38% to 5% over the past few months.
...
But the scarcity of vaccines means they've only been available for patients and their close contacts in Siguiri. As diphtheria continues to spread in Guinea, Mutreja worries about growing antibiotic resistance and the spread of new variants, which could render existing antitoxins and vaccines ineffective.
...

Why diphtheria is making a comeback

https://www.npr.org/sections/goatsandsoda/2024/01/23/1226155791/why-diphtheria-is-making-a-comeback

With an effective vaccine, cases of the potentially fatal disease plummeted. But West Africa is now seeing thousands of new cases and hundreds of deaths.

**Pathfinder** · February 20, 2024, 10:25 AM

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 5: 29 January - 4 February 2024
Data as reported by: 17:00; 4 February 2024
...

Guinea

Diphtheria

3 445 Cases
83 Deaths
2.4% CFR

EVENT DESCRIPTION

Guinea has been experiencing a diphtheria outbreak
with a significant number of reported cases.

From weeks 1 to 5 of 2024 (ending 4 February), there were
1 184 suspected cases and five deaths, averaging 237
suspected cases per week during this period. Although
there has been a slight decline in cases since week 3
of 2024, the epidemic curve shows a general trend of
increasing number of reported cases with progressively
higher peaks since the beginning of the outbreak.

Since the outbreak began on 4 July 2023, until
4 February 2024, Guinea has recorded 3 445 suspected
cases of diphtheria, including 3 207 confirmed cases
and 83 deaths, resulting in a case fatality rate (CFR) of
2.4% among suspected cases.

Of the confirmed cases, 39 (1.2%) were laboratory
confirmed, 107 (3.3%) were epidemiologically linked,
and 3 061 (95.4%) were clinically compatible. Females
accounted for 52% of cases and 65% were under 15
years of age.

Initially, the outbreak was localized in the Kankan region.
As of week 3 of 2024, seven of Guinea’s eight regions
have been affected, including the capital, Conakry.
Kankan region accounts for most reported cases, with
96.7% (3 332 cases) attributed to this region. Boké
region is the only one that has not reported any cases.

PUBLIC HEALTH ACTIONS

The response to the outbreak is being coordinated
by a national strategic committee and regional
coordination teams that include several partners.

Intensified surveillance efforts in active case finding
along with a strategy for tracing outpatient cases are
being implemented

Ongoing community engagement efforts continues,
encompassing diphtheria and vaccination
awareness sessions with various community
stakeholders, including contacts, traditional leaders,
and the general population.

Clinical case management protocols are being
implemented, combined with the provision of
psychosocial support to households affected by
diphtheria.

A vaccination campaign is being organized with
support from GAVI.

SITUATION INTERPRETATION

Since the outbreak began in July 2023, significant
portion of all suspected diphtheria cases were
reported in the first five weeks of 2024. Although
surveillance has improved, the persistent gradual
rise in cases suggests the presence of underlying
factors exacerbating the situation. Close monitoring
is essential, and further response measures are
imperative to effectively control this outbreak.

Site under maintenance | WHO | Regional Office for Africa

https://www.afro.who.int/countries/guinea/publication/outbreaks-and-emergencies-bulletin-week-05-29-january-4-february-2024

The World Health Organization (WHO) is building a better future for people everywhere. Health lays the foundation for vibrant and productive communities, stronger economies, safer nations and a better world. Our work touches lives around the world every day – often in invisible ways. As the lead health authority within the United Nations (UN) system, we help ensure the safety of the air we breathe, the food we eat, the water we drink and the medicines and vaccines that treat and protect us. The Organization aims to provide every child, woman and man with the best chance to lead a healthier, longer life.

**Pathfinder** · July 22, 2024, 01:08 PM

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 27: 1 - 7 July 2024 2024
Data as reported by: 17:00; 7 July 2024
...

Guinea

Diphtheria

5 986 Cases
133 Deaths
2.2% CFR

EVENT DESCRIPTION

The diphtheria outbreak in Guinea is ongoing, with a general
decreasing trend in the number of new cases reported. In
epidemiological week 27 (week ending 6 July 2024), a total of
80 suspected cases, including five deaths (CFR 7.0%), were
reported across seven districts: Siguiri 76.3% (n=61), Kankan
7.5% (n=6), Mandiana 6.3% ( n=5), Dinguiraye 3.8% (n=3),
Conakry 2.5% (n=2), Dalaba 2.5% (n=2) and Forecariah 1.3%
(n=1). Of the 80 suspected cases, 71 were confirmed positive,
including 67 clinically compatible cases and four laboratory
confirmed cases.

Cumulatively, from epidemiological week 12 to 27, a total
of 5 986 suspected cases, including 133 deaths (CFR
2.2%), were reported across seven regions: Kankan 95%
(n= 5 734), Mamou 2.0% (n=122), Conakry 1.0% (n=60),
Faranah 0.5% (n=33), Kindia 0.3% (n=23), Labé 0.1%(n=13),
and N’Nzérékoré 0.01% (n=1). The Kankan region in Siguiri
health district remains the epicenter of this outbreak, with
the highest reported cases (n=5 734). Of the 5 986 reported
cases, 5 559 (96%) were classified as clinically compatible, 82
(1.47%) were confirmed in the laboratory, and 109 (1.96%) were
confirmed by epidemiological link.

The age group between 6 and 10 is the most affected,
accounting for 23.0% (n=1 205) of all reported cases. This is
followed by the age group between 11 and 15, representing
19.0% (n=1 304), and then the age group between 0 and 5,
with 17.0% of all cases. Females make up 9.0% of all reported
cases. Since the beginning of the outbreak (week 12), 32 154
contacts of confirmed cases have been identified and followed
up.

PUBLIC HEALTH ACTIONS

The WHO supports the Ministry of Health in conducting
vaccination campaigns against diphtheria in affected
regions. Since the beginning of the outbreak, 204 801 people
have been vaccinated with Pentavalent and TD vaccines in
the Siguiri health district. WHO received funds from ECHO to
support diphtheria response activities in Guinea.

Coordination meetings, including Incident Management
team meetings, are held regularly

The Ministry of Health, in collaboration with WHO and
other health partners, is conducting surveillance activities,
including investigations of suspected diphtheria cases,
contact tracing, and follow-up.

Ongoing infection prevention and control activities
include briefings targeting healthcare workers to minimize
nosocomial transmission.

Risk communication and community engagement activities
are ongoing, including education and community dialogue
in affected regions.

SITUATION INTERPRETATION

Although the diphtheria outbreak situation in Guinea is
improving, additional efforts are required to reinforce the
surveillance system in the affected and neighbouring
regions to ensure no cases are missed. Furthermore,
it is essential to accelerate vaccination campaigns in
the most affected areas to halt the transmission chain
of the current outbreak. Infection prevention and control
measures should also be strengthened to prevent
nosocomial transmission. Enhancing clinical case
management is critical to reduce mortality. Reinforcing
risk communication activities within the community is
crucial to ensure affected children are brought to the
hospital promptly.

403 Forbidden

https://iris.who.int/handle/10665/378249

**Pathfinder** · October 2, 2024, 11:21 AM

Translation Google
In Guinea, community relays fight against a diphtheria epidemic

October 2, 2024

Siguiri – Guinea is facing a diphtheria epidemic declared in July 2023. The Kankan region, with the Siguiri health district, is the epicenter of the epidemic concentrating more than 96% of cases. Siguiri is a gold mining area in the center-east of the country where thousands of miners and their families live and move constantly.

As of September 21, 2024, 6,502 cases have been recorded in epidemic treatment centers. From the first hours of the epidemic, the World Health Organization (WHO) supported the Ministry of Health, through the Prefectural Directorate of Health (DPS) by activating an Epidemiological Treatment Center (CT-Epi) for the management of patients in Siguiri.

Hospitalized urgently at CT-Epi, Mohamed Fofana remembers with emotion a young girl who arrived in critical condition: “Her parents had waited too long to bring her and she died the next day,” explains Mohamed, a motorcycle taxi driver from Bouré Balato, a locality dominated by artisanal gold mining. “Some frightening rumors still discourage people from seeking medical care and getting vaccinated.”

Without prompt treatment with diphtheria toxoid, the mortality rate from diphtheria can be as high as 40%, especially among young children. The outbreak, which occurred in a region where diphtheria had been free for more than 20 years, is compounded by the density and constant mobility of the population, poor living conditions, low vaccination coverage and ineffective treatment methods.

In Guinea, vaccination coverage for the combined diphtheria-tetanus-pertussis (DTP) vaccine remains low, at just 47% in 2022, well below the 80-85% required by WHO to achieve herd immunity. “It is very difficult to plan our prevention activities in this region, because each new mine attracts populations who form temporary villages, before migrating to other operating areas,” explains Dr. Cheick Oumar Konaté, Prefectural Director of Health in Siguiri.

In addition to advanced vaccination strategies, WHO has trained 70 active case finders and contact tracing workers, as well as more than 170 community outreach workers to raise awareness about the importance of the vaccine. These outreach workers play a crucial role in early detection of cases and in combating misinformation. Education on the symptoms of diphtheria is also essential, as the disease can easily be mistaken for a sore throat or a common cold.

“When my son contracted diphtheria, my wife first tried to treat him with traditional methods,” says Abdoulaye Dansoko, a municipal councilor in Kourémalé, on the border with Mali. “After two days, his condition worsened and I was very worried. The community relays finally sent us to the Epidemiological Treatment Center (CT-Epi) in Siguiri where he was treated and the whole family was vaccinated. It was all free.”

To strengthen the response to the outbreak, WHO has also provided diphtheria treatments and collection kits with funding from the European Commission's Civil Protection and Humanitarian Aid Operations (ECHO).

With the management at CT-Epi and awareness-raising among communities, the case fatality rate, which was 36% in July 2023, fell to 2.83% in July 2024. “Early detection of cases by community relays allowed for rapid management and helped save many lives,” underlines Dr. Chérif Ibrahima Sory, epidemiologist at the WHO office in Guinea.

In treatment centers, the cure rate is over 97%. “Diphtheria is an extremely serious disease,” recalls Mohamed Fofana, now recovered. “Whoever rejects vaccination and treatment is deceiving himself and endangering the health of others. After this experience, I am ready to become a champion of vaccination.”

https://www.afro.who.int/fr/countrie...e-de-diphterie

**Pathfinder** · October 26, 2024, 08:12 AM

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 40: 30 September to 6 October 2024
Data as reported by: 17:00; 6 October 2024
...
Guinea

Diphtheria

6 524 Cases
175 Deaths
2.7% CFR

EVENT DESCRIPTION

WHO continues to closely monitor the diphtheria outbreak in
Guinea. Since our last report as of 25 August 2024 (Weekly
Bulletin 34,2024), 115 new suspected cases, including 14
new deaths, have been reported. A fluctuating case trend
has been observed between week 34 and week 39 of
2024, with an average of 26 suspected cases reported per
week. During epidemiological week 39 of 2024 (ending 29
September 2024), 23 clinically compatible cases and three
deaths were reported from four health districts of Kankan
(22 cases; 3 deaths) and Kindia (1 case) regions.

From week 11, 2023 to week 39, 2024, a total of 6 524
suspected cases were reported from seven regions, namely
Kankan (6 230 cases; 95.5%), Mamou (136 cases; 2.2%),
Conakry (69 cases; 1.1%), Faranah (37 cases; 0.5%), Kindia
(36 cases;0.6%), Labé (13 cases; 0.1%), and Nzérékoré
(3 cases;0.1%). Among the 6 524 suspected cases, 5
902 (90.5%) were clinically compatible, 109 (1.7%) were
detected by epidemiological link, 86 (1.3%) were laboratory
confirmed and 427 (6.5%) were classified as non-cases. A
total of 175 cumulative deaths were recorded in Kankan
(161), Faranah (5), Kindia (3), Conakry (2), Mamou (2), and
Nzérékoré (2) regions.

Siguiri health district in Kankan region remains the epicenter,
with 6 020 (92.3%) cumulative cases and 141 (80.6%)
cumulative deaths reported since the beginning of the
outbreak. Overall, the most affected age groups are 6-10
years (23%), 11-15 years (20%) and 16-20 years (19.0%),
with females accounting for 59.0% of the cases.

PUBLIC HEALTH ACTIONS

Coordination meetings of the national technical
committee and technical working groups for diphtheria
continue to be held under the leadership of the Ministry
of Health, with the support and active participation of
WHO and other partners.

Case investigation, active case search, contact tracing
and case data entry into DHIS2 are ongoing.
Sample collection and transportation to the reference
laboratory in Conakry continues with the support of the
UN Humanitarian Air Service.

Antibiotic prophylaxis (Amoxicillin, Azithromycin) is
provided to contacts of diphtheria cases, and clinical
management of cases is ongoing in the affected areas.
The two vaccination campaign rounds were completed
in Siguiri by July 2024.

Risk communication activities are ongoing including
community sensitization on the prevention of diphtheria
through routine immunization and sensitization of
contacts of confirmed cases on the importance of
vaccination.

SITUATION INTERPRETATION

After more than a year of public health response to the
protracted diphtheria outbreak in Guinea, some positive
efforts have been noted in the management of cases
and contacts, including high vaccination coverage
among contacts (reaching up to 100% weekly) and a
significant reduction in ambulatory management of
cases with all diphtheria cases now being treated at
the treatment centre in Siguiri. Nonetheless, vaccination
remains challenging as only a few communes in Siguiri
health district were covered during the two vaccination
campaign rounds. Therefore, WHO and other partners
are encouraged to scale up their technical and financial
support for mass vaccination campaigns in all the
affected districts and regions.

Weekly bulletins on outbreaks and other emergencies | WHO | Regional Office for Africa

https://www.afro.who.int/health-topics/disease-outbreaks/outbreaks-and-other-emergencies-updates

The World Health Organization (WHO) is building a better future for people everywhere. The Organization aims to provide every child, woman and man with the best chance to lead a healthier, longer life.

**Pathfinder** · January 10, 2025, 11:20 AM

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 52: 23 to 29 December 2024
Data as reported by: 17:00; 29 December 2024
...
Guinea

Diphtheria

6 711 cases
207 Deaths
3.0% CFR

EVENT DESCRIPTION

Guinea has been battling a diphtheria outbreak since
Week 27 of 2023, with cases reported in several regions,
including Conakry, Faranah, Kankan, Labé, Mamou,
Kindia, and N’Zérékoré. Kankan, region and particularly
the Siguiri health district, has been the hardest hit.
Despite ongoing public health interventions, the outbreak
persists.

In epidemiological week 50, 2024, 18 new suspected
cases were reported in four districts: Ratoma (10 cases,
55.6%), Lelouma (2 cases, 11.1%), Siguiri (5 cases,
27.8%), and Mandiana (1 case, 5.6%). Among these, 17
cases were classified as clinically compatible, with one
laboratory-confirmed case. A death was also reported
during this week, bringing the cumulative number of
deaths to 207 since the outbreak began. In addition, 38
contacts were identified.

From Week 27 of 2023 to Week 50 of 2024, 6 711
suspected cases have been reported, including 6 110
clinically compatible cases, 109 epidemiologically linked
cases, 100 laboratory-confirmed cases, and 427 non-
cases. The overall fatality rate (CFR) is 3.3%.

Children aged 6–10 years represent the largest proportion of cases
(23%), followed by those aged 11–15 (20.0%). Females accounted
for 59.0% of the cases, and most affected individuals were
unvaccinated.

Since the onset of this outbreak, over 35 123 contacts
have been identified nationwide. Response teams have
consistently followed up with 100% of these contacts,
ensuring timely administration of antibiotic prophylaxis
to 63.1% of them.

PUBLIC HEALTH ACTIONS

Key actions taken by the Ministry of Health and partners
include:

Regular coordination meetings, including weekly
epidemiological updates and follow-up on implementing
action points from grading meetings.

Active case finding, contact tracing, and monitoring
activities are ongoing. In Week 50, 38 contacts were
identified and placed under antibiotic prophylaxis in the
Kankan region.

Samples are being sent to the INSP reference laboratory
in Conakry for confirmation.

Patients receive antibiotics and diphtheria antitoxin.
Healthcare workers are trained in infection prevention and
control measures to reduce nosocomial transmission.

Vaccination efforts continue with catch-up campaigns
targeting missed children through the Big Catch-Up
initiative (Penta, Td), ring vaccination around notified
positive cases in Kankan, and vaccination of cases and
close contacts at CTEPI are conducted.

Awareness campaigns via local radio stations and direct community
sensitization on diphtheria prevention and vaccination are ongoing.
...
SITUATION INTERPRETATION

The diphtheria outbreak in Guinea remains a significant public health concern, requiring sustained and strengthened
efforts in vaccination, surveillance, and case management. Collaborative efforts between the Ministry of Health,
international partners, and local communities are critical to controlling the outbreak, minimizing deaths, and preventing
future cases.

Weekly bulletins on outbreaks and other emergencies | WHO | Regional Office for Africa

https://www.afro.who.int/health-topics/disease-outbreaks/outbreaks-and-other-emergencies-updates

The World Health Organization (WHO) is building a better future for people everywhere. The Organization aims to provide every child, woman and man with the best chance to lead a healthier, longer life.

Announcement

Guinea - Diphtheria outbreak 2023-2025

Guinea - Diphtheria outbreak 2023-2025

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment