There were 10 toxigenic cases of diphtheria and one death reported in England in 2019, the latest statistics from Public Health England (PHE) show.
All cases were due to Corynebacterium ulcerans. All cases were linked to companion or domestic animals.
Three cases had a cutaneous presentation, one had a respiratory presentation including a membrane, two had a mild respiratory infection, one had both cutaneous and mild respiratory symptoms and two were asymptomatic contacts of a case identified from throat swabs.
The PHE statistics also show there were four cases of tetanus reported in England from January 2019 to December 2019. No tetanus-related deaths were recorded during this period.
The four cases were aged 39-70 years old; three were male. Of the four cases, 2 cases were born before 1961 when routine childhood vaccination was introduced in the UK.
Three cases presented with mild symptoms; one had very severe symptoms. All cases were hospitalised and two were admitted to intensive treatment unit.
The three milder cases had sought medical advice at the time of injury; two were given antibiotics and two were given tetanus toxoid booster, but none were recorded as being offered post-exposure prophylaxis with intramuscular tetanus-specific immunoglobulin (TIG), despite recommendations that all exposed individuals with unknown vaccination status be offered prophylaxis with TIG following a tetanus-prone wound.
All four cases received intravenous immunoglobulin or TIG (intramuscular) during hospitalisation.