Rise in Diphtheria Cases in Western Australia
Cases of diphtheria, a potentially deadly bacterial infection, have seen a significant increase in the far north of Western Australia. According to the WA Country Health Service, there were 27 notified cases of diphtheria in the Kimberley region, a sharp rise from seven cases reported just a month earlier. This surge has raised concerns among public health officials, who are closely monitoring the situation.
Diphtheria is a rare disease that typically affects communities with low socio-economic status and limited access to healthcare. It is also associated with low vaccination rates. Before this outbreak, diphtheria had not been detected in the Kimberley for half a century. Public health physician Gary Dowse described the current situation as an urgent public health issue, though the exact cause of the outbreak remains unclear.
Understanding Diphtheria
Diphtheria is a contagious bacterial infection that spreads easily between people through physical contact or respiratory droplets. There are two main types: respiratory (affecting the throat) and cutaneous (affecting the skin). Dr Dowse explained that the respiratory form can lead to severe complications, including the formation of a membrane or plaque in the back of the throat that can block the airway and cause life-threatening breathing difficulties.
The cutaneous form involves infected sores and wounds that may take a long time to heal. Dr Dowse noted that the current outbreak appears to be spreading more readily than usual, though the reasons for this are not yet understood. He emphasized that diphtheria had effectively been eradicated in Australia, making this outbreak particularly concerning.
In the past year, cases of diphtheria have emerged in the Northern Territory, and this year the disease has now spread into the Kimberley. About 75% of the cases in the outbreak are skin infections, while 25% are respiratory. One case has been life-threatening, with the patient flown to Perth for intensive treatment.
Response and Control Measures
Vaccination remains the most effective way to prevent diphtheria. Clinicians across the Kimberley, Pilbara, and Goldfields are being advised to remain vigilant for patients presenting with suspicious skin sores, infected wounds, or upper respiratory illnesses. Dr Dowse stressed that many doctors may not have encountered the disease before, so reminders about its existence and increasing prevalence are essential.
A state government spokesperson confirmed that a contact tracing system has been established, and treatment is being provided to those affected. At-risk individuals are also being supported to receive booster vaccinations. Targeted diphtheria vaccine booster programs have been implemented in communities where cases have occurred.
Potential for Further Spread
University of WA public health lecturer Barbara Nattabi highlighted that low vaccination rates combined with limited access to healthcare create a “double whammy” for vulnerable communities. She warned that the disease is likely to continue spreading, especially given the interconnected nature of these communities.
Even with antibiotic treatment, up to one in 10 people with respiratory symptoms die, with a higher mortality rate among children, according to the Australian Centre for Disease Control.
Alternative Solutions and Recommendations
Curtin University international health professor Jaya Dantas recommended expanding vaccinations under the National Immunisation Program. She pointed out that childhood vaccinations are free under the scheme, but adult vaccinations are not. Other groups included in the program are pregnant women and refugees.
Dr Dantas suggested that the program should be expanded to include the First Nations population, particularly in light of the Kimberley outbreak. She noted that diseases like measles, smallpox, and polio have been eradicated globally, but diphtheria is now resurging.
