Diptheria cases in the UK have surged over the past year, linked to illegal immigrants crossing the English Channel in small boats, according to official figures.
The increase of UK cases mirrors similar outbreaks across Europe, which were also among immigrants, particularly young males from Afghanistan and Syria, according to several reports for the European Congress of Clinical Microbiology and Infectious Diseases in Copenhagen.
Diphtheria, a highly contagious bacterial infection which can be fatal, is rare in the UK. The country has routinely vaccinated babies and children against it since the 1940s.
Fewer than 12 cases per annum have been reported in England over the past decade, but between January 2022 and March this year, 74 cases were detected among illegal immigrants in England, with 73 identified in 2022, according to researchers at the UK Health Security Agency (UKHSA), which drafted one report.
Almost all of the cases (97 percent) were among young Afghan males, and over half (53 percent) of the patients were under-18s with unknown vaccination history, the researchers said.
Just more than half of the cases had skin lesions or wounds acquired before their arrival in the UK, suggesting they were infected “during extensive travel through Europe,” the researchers said, while stressing that local transmission cannot be ruled out.
Some 12 percent of the patients had no symptoms. Their infections were detected through screening or contact tracing. One person died from the diphtheria infection.
Outbreaks Across Europe
Similar outbreaks have also been seen across Europe, the papers said.In July 2022, Germany identified seven cases of diphtheria among immigrants.
As of March 2023, the outbreak has affected 189 immigrants, mostly from Afghanistan and Syria, “despite the fact that diphtheria incidence and vaccination coverage in Afghanistan and Syria has remained mostly unchanged over the last few years,” German researchers said.
Another paper examined some cases in Switzerland (52), Germany (118), the UK (59), Austria (69), France (30), Belgium (21), Norway (8), the Netherlands (5), Italy (3), and Spain (1), identifying “four distinct clusters of cases.”
“The fact that there are four clusters indicates there are four distinct chains of transmission, which may each be traceable on their own. In addition, the four clusters differ in their complement of antimicrobial resistance genes and phenotypes; which may imply different clinical care approaches and stringency of control measures,” the researchers said.
“This is a multiclonal outbreak with evident transmission among migrant people. The close relatedness within clusters suggests recent transmissions, possibly occurring during travel and within migrant facilities. Where exactly transmission events occurred remains to be determined, but it is likely linked to lack of proper vaccination among the migrant people. The number of detected cases in collaborating countries decreased significantly in January 2023,” they added.
The European Society of Clinical Microbiology and Infectious Diseases, the NGO that hosts the annual conference, said its report has been peer-reviewed, but not yet been submitted to a medical journal for publication.
In the UK, the number of people smuggled into the country in small boats has increased dramatically over the past four years, from 299 people in 2018 to 45,755 people in 2022.
Last year, the number of small boat arrivals accounted for almost 85 percent of all irregular immigrants detected (54,090), compared to 4,569 inadequately documented air arrivals (8 percent). There were also 3,456 people who were detected in the UK (6 percent) and 310 people who were detected at British sea ports, Home Office figures show.
But the crossings during the 90-day period this year and last year occurred on exactly the same number of days, suggesting the reduction may not be owing to weather conditions.
