Aboriginal communities at centre of Australia’s worst diphtheria outbreak in decades

Health authorities are working with Aboriginal Community Controlled Health Organisations across the Northern Territory and Western Australia as Australia responds to its largest recorded diphtheria outbreak, with the vast majority of cases involving Aboriginal and Torres Strait Islander people.

As at 26 May, 254 cases had been reported or notified nationally, according to Federal Health Minister Mark Butler. About 60 per cent were in the Northern Territory, with most of the remainder in Western Australia’s Kimberley region and smaller numbers in Queensland and South Australia.

One death has been confirmed as a result of diphtheria, Mr Butler said, while reports of a second suspected death had not been confirmed by the NT Government.

Chief Medical Officer Professor Michael Kidd declared diphtheria a Communicable Disease Incident of National Significance on 22 May, saying a nationally coordinated response would help get vaccines, medicines, staff and support to communities most in need.

Mr Butler said the outbreak was “a very serious outbreak, of deep concern” to governments and Aboriginal medical services, with well over 90 per cent of cases in the NT and WA involving Indigenous Australians.

The Australian Government has announced a $7.2 million response package, including surge workforce support, vaccines, antibiotics, and funding for culturally safe communications and community liaison through Aboriginal Community Controlled Health Organisations.

Most Western Australian cases have been recorded in the Kimberley.

University of New South Wales Kirby Institute biosecurity program head Professor Raina MacIntyre said the pattern of cases marked a sharp departure from previous decades, when diphtheria in Australia was usually rare and travel-related.

She described the current outbreak as an “unprecedented epidemic”, with most cases involving skin infection and about a quarter involving respiratory diphtheria.

Diphtheria is a potentially fatal bacterial infection that can affect the skin or the respiratory tract. Skin or cutaneous diphtheria can cause slow-healing ulcers and lesions. Respiratory diphtheria can cause severe breathing difficulty and historically caused widespread childhood deaths before mass vaccination.

The Australian Centre for Disease Control says most current cases have been relatively mild, likely reflecting the protective effect of prior vaccination, although vaccination does not always prevent carriage or transmission. Authorities say people who are unvaccinated, or whose last vaccine dose was more than 10 years ago, are at greatest risk of severe illness.

Health agencies are urging Aboriginal community members and others in higher-risk regions to check their diphtheria vaccinations and seek advice from an Aboriginal Medical Service, GP, pharmacy or local health clinic.