WHO laboratory manual for the diagnosis of diphtheria and other related infections

Overview

Diphtheria and related infections caused by toxigenic strains continue to be reported around the world and are lethal resurgent infectious diseases. The rarity of cases, as well as the expense and complexity associated with laboratory diagnosis, mean that many countries ceased to screen throat specimens, and therefore, expertise and recognition of the organism have declined. Public health management cannot be effective without the appropriate microbiological diagnosis of the disease. Diphtheria is re-emerging in areas where population immunity through vaccination has not been maintained. Therefore, both clinicians and laboratory personnel should always maintain a high index of suspicion in patients presenting with signs and symptoms of respiratory or cutaneous diphtheria, particularly after being in countries endemic for the disease.

Diphtheria cases are persisting in many areas in the world with several thousand being reported annually, but the numbers are underestimated due to the lack of surveillance infrastructure in many areas.

This manual considers all the developments listed above and incorporates extensive sections on laboratory diagnostics, molecular technologies and serology. It extends the repertoire of infections to all the potentially toxigenic corynebacteria; Corynebacterium diphtheriae, Corynebacterium ulcerans and Corynebacterium pseudotuberculosis. The manual is aimed for global use and will hopefully fulfil the needs of all laboratories including those with minimal resources.