Confirmed diphtheria case first locally in more than decade

Girl, now recovering, was fully vaccinated, doctor says.

A Montgomery County girl recently diagnosed with diphtheria — the first such case in the Miami Valley in at least a decade — might have been fully vaccinated, a local health official said.

Prevalent before vaccinations to prevent it began in the 1920s, diphtheria affects the tonsils, throat, skin and nose. According to the Centers for Disease Control and Prevention, fewer than five cases were reported in the United States in past 10 years.

“I have never seen diphtheria before,” said Dr. Joseph Leithold, a family practitioner in Beavercreek. “It’s extremely rare.”

The local case was reported when a girl — whom health officials described as an “adolescent” — was hospitalized with symptoms similar to strep throat.

Dr. Thomas Herchline, medical director for Public Health — Dayton & Montgomery County, said the girl was released from Dayton Children’s Hospital earlier this month. Herchline said the girl might have been fully vaccinated.

“Anyone getting diphtheria in the United States is rare,” he said. “The bottom line is that we know the vaccine is highly effective. The possibility is there that this was a vaccine failure.”

According to the Ohio Department of Health, diphtheria is spread through close contact with discharges from an infected person’s nose, throat, eyes or skin lesions. Symptoms — which usually appear two to five days after infection — include fever, sore throat and fatigue. Breathing can become difficult due to a membrane that may develop on the tonsils. An infection in the skin could cause a scaling rash.

In general, the bacteria that causes diphtheria can produce a toxin responsible for many of the problems associated with the disease. The bacteria in the throat of the Montgomery County girl — who is now at home recovering — did not produce that toxin.

“From Public Health’s standpoint, our approach is to identify this young woman’s close contacts,” Herchline said.

As a result, family members and others within close proximity to the girl were treated for diphtheria. No other cases have been reported, and officials don’t expect others.

Diphtheria was once a major cause of death and illness among children. According to the Centers for Disease Control and Prevention, 206,000 cases were reported in the U.S. in 1921 and resulted in 15,520 deaths. While very few cases have been recorded in the United States recently, the disease remains a concern around the world. In 2011, 4,887 cases were reported to the World Health Organization.

Death occurs in roughly 5 to 10 percent of all cases, according to the Ohio Department of Health. However, serious complications such as paralysis, heart failure and blood disorders may follow if the disease goes untreated.

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