Evidence map›Paper›PMID 33109284›Full record

ArticleEpidemiology and infection2020

A patient with respiratory toxigenic diphtheria in Greece after more than 30 years.

T Georgakopoulou, K Tryfinopoulou, A Doudoulakakis, F Nikolaou, I Magaziotou, A Flountzi, N K Fry, D J Litt, M Damala, I Spiliopoulou and 8 more

Open access · goldAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Epidemiology and infection, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 6 institutions in 2 countries.

T GeorgakopoulouDepartment for Vaccine Preventable Diseases & Congenital Diseases, National Public Health Organization (NPHO), Athens, Greece.ORCID 0000-0001-9559-7476
K TryfinopoulouCentral Public Health Laboratory, National Public Health Organization (NPHO), Athens, Greece.
A DoudoulakakisDepartment of Microbiology, P. & A. Kyriakou Children's Hospital, Athens, Greece.
F NikolaouPaediatric Intensive Care Unit, P. & A. Kyriakou Children's Hospital, Athens, Greece.
I MagaziotouDepartment for Vaccine Preventable Diseases & Congenital Diseases, National Public Health Organization (NPHO), Athens, Greece.
A FlountziCentral Public Health Laboratory, National Public Health Organization (NPHO), Athens, Greece.
N K FryWHO Global Collaborating Centre for Reference and Research on Diphtheria and Streptococcal Infections, Reference Microbiology Division, National Infection Service, Public Health England, London, UK.
D J LittWHO Global Collaborating Centre for Reference and Research on Diphtheria and Streptococcal Infections, Reference Microbiology Division, National Infection Service, Public Health England, London, UK.
M DamalaDepartment of Microbiology, P. & A. Kyriakou Children's Hospital, Athens, Greece.
I SpiliopoulouCentral Public Health Laboratory, National Public Health Organization (NPHO), Athens, Greece.
E Liatsi-DouvitsaResearch Unit of Advanced Composite Nano Materials & Nanotechnology, School of Chemical Engineering, National Technical University of Athens, Athens, Greece.
E LebessiDepartment of Microbiology, P. & A. Kyriakou Children's Hospital, Athens, Greece.
G PanayiotakopoulosNational Public Health Organization (NPHO), Athens, Greece.
M Tsolia2nd Department of Paediatrics, National and Kapodistrian University of Athens School of Health Sciences, Greece.
G SaroglouInternal Medicine Department, Metropolitan Hospital, Athens, Greece.
M TheodoridouFirst Department of Pediatrics, Aghia Sophia Children's Hospital, University of Athens, Greece.
S TsiodrasNational Public Health Organization (NPHO), Athens, Greece.
A EfstratiouWHO Global Collaborating Centre for Reference and Research on Diphtheria and Streptococcal Infections, Reference Microbiology Division, National Infection Service, Public Health England, London, UK.
National Public Health Organization · GRPanagiotis & Aglaia Kyriakou Children's Hospital · GRNational and Kapodistrian University of Athens · GRPublic Health England · GBMetropolitan Hospital · GRNational Technical University of Athens · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The introduction of treatment and systematic vaccination has significantly reduced diphtheria mortality; however, toxigenic strains continue to circulate worldwide. The emergence of an indigenous diphtheria case with fatal outcome in Greece, after 30 years, raised challenges for laboratory confirmation, clinical and public health management. Toxigenic Corynebacterium diphtheriae was isolated from an incompletely vaccinated 8-year-old boy with underlying conditions. The child passed away due to respiratory distress syndrome, before the administration of diphtheria antitoxin (DAT). All close contacts in family, school and hospital settings were investigated. Pharyngeal swabs were obtained to determine asymptomatic carriage. Chemoprophylaxis was given for 7 days to all close contacts and a booster dose to those incompletely vaccinated. Testing revealed a classmate, belonging to a subpopulation group (Roma), and incompletely vaccinated, as an asymptomatic carrier with an indistinguishable toxigenic strain (same novel multilocus sequence type, designated ST698). This case highlights the role of asymptomatic carriage, as the entry of toxigenic strains into susceptible populations can put individuals and their environment at risk. Maintenance of high-level epidemiological and microbiological surveillance, implementation of systematic vaccination in children and adults with primary and booster doses, availability of a DAT stockpile, and allowing timely administration are the cornerstone to prevent similar incidents in the future.

Indexed as

AdultAmpholyte MixturesAnti-Bacterial AgentsAntibodies, BacterialChildClarithromycinContact TracingCorynebacterium diphtheriaeDiphtheriaDiphtheria-Tetanus-acellular Pertussis VaccinesFatal OutcomeGreeceHumansMaleAmpholyte MixturesAnti-Bacterial AgentsAntibodies, BacterialClarithromycinDiphtheria-Tetanus-acellular Pertussis VaccinesDATDiphtheriadiphtheria vaccinationepidemiological surveillanceGreece

Identifiers

PMID33109284
PMCPMC7770372
OpenAlexW3097765461

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.