Diphtheria outbreak in Norway: Lessons learned

Abstract

We describe an outbreak of diphtheria in Norway that occurred in 2008 and affected 3 unvaccinated family members. The epidemic caught the public health system off-guard on most levels; the diagnosis was distrusted due to its rarity, no diphtheria anti-toxin was available, and notification procedures were not rigorously followed.

Keywords::

• Diphtheria
• vaccination
• diphtheria anti-toxin
• DAT
• Corynebacterium diphtheriae

Acknowledgements

We thank A. Efstratiou, Health Protection Agency, Colindale, London, UK for confirming the bacterial diagnosis, toxigenicity, and for ribotyping; Ø. Løvoll and F. L. Nilsen for their contribution to containing the outbreak; A. R. Alme and G. Rødahl for skilful technical work; and several other colleagues are thanked for their public health work in containing the outbreak.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.