The federal government has stepped in to address a diphtheria outbreak that has crossed several state borders, unveiling a multi-million dollar package for more vaccines and the workforce to deliver them, as it seeks to quell the largest outbreak of the disease since records began.
Once considered almost eradicated, there have now been about 230 cases of diphtheria reported so far this year across Australia with a likely diphtheria-related death, which would be the first fatality from the disease in almost a decade.
The majority of the cases are in the Northern Territory but the outbreak is also spreading across Western Australia, South Australia and Queensland.
The outbreak has caused a significant strain on health services. (ABC News: Xavier Martin)
The $7.2 million package will include money for the National Critical Care and Trauma Response Centre for a surge workforce to administer booster vaccinations and treatments, as well as procuring additional vaccines and antibiotics.
Federal Health Minister Mark Butler said while the package was primarily for the Northern Territory, he would be writing to other affected states to see if they also needed Commonwealth support.
“This is a very serious outbreak of a very serious disease,”
he said.
“It’s important we control it but it’s also important that people get vaccines into their arms in affected areas as quickly as possible because at the end of the day that is the most effective way to protect yourself and those around you.”
Diphtheria is a life-threatening and highly contagious bacterial infection that is treated with antibiotics, and can affect the nose, throat and airways or the skin.
It spreads through respiratory droplets from coughing or sneezing, or direct contact with infected wounds.
Health authorities consider vaccination one of the best ways to prevent diphtheria, with a consistent schedule of primary doses and booster shots.
The support package is aimed at boosting waning vaccination rates, with routine childhood immunisation coverage — which includes the diphtheria vaccine — falling to its lowest level in five years in 2025.
Mr Butler said the outbreak was mainly affecting adults, however cautioned the exact cause of the sudden rise in cases remained unclear.
“There has been a reduction in vaccinations broadly across the community since COVID, we’ve seen that right across the world,” he said.
“I think it’s too early to say whether vaccination rates are the driving factor or the main driving factor behind this outbreak.”
Professor MacIntyre says falling vaccination rates was a “fundamental problem”. (ABC News: Brendan Esposito)
Head of the biosecurity program at the Kirby Institute, Raina MacIntyre, believed falling vaccination rates due to misinformation was a “fundamental problem”, and missing out on boosters was problematic as immunity wanes over time.
Professor MacIntyre said data from the Australian Centre for Disease Control (CDC) last month showed that almost 80 per cent of respiratory diphtheria cases were in people who had been given at least three doses of the vaccine and more than half of those with skin diphtheria had also been vaccinated.
“The occurrence of diphtheria in vaccinated people may reflect partial vaccination, missed booster doses, or weakened immunity in fully vaccinated people,” Professor MacInytre said.
Infectious diseases expert Dr Mattew Mason at the University of the Sunshine Coast said vaccine hesitancy and misinformation weren’t the only reasons for under-vaccination.
“The widespread nature of this outbreak clearly shows there’s been a failure in our public health response,” he said.
“[This] reflects decades of under-investment in culturally appropriate, community-led health infrastructure … when working with the Aboriginal or Torres Strait Islander community trust is really important and it’s hard to build trust with a fly-in, fly-out service with different doctors or nurses every couple of weeks.”
NSW announces targeted vaccine program
Part of the federal government’s package will also go to National Aboriginal Community Controlled Health Organisations (NACCHO) for community liaison and on-the-ground public health supports, with the majority of the cases so far recorded in remote Aboriginal communities.
NACCHO Medical Advisor Megan Campbell said efforts to contain the outbreak had been complicated by workforce shortages, low vaccination rates and logistical barriers involved in trying to access remote communities.
“There’s no doubt that the diphtheria outbreak is placing an incredible strain on Aboriginal community controlled health services in the Northern Territory and in other outbreak affected areas,” Dr Campbell told the ABC.
The government package was primarily for the Northern Territory. (ABC News: Xavier Martin)
“So this funding is much needed and it’s essential now that how the funding is allocated and used and all aspects of the diphtheria outbreak response are determined in true partnership with the Aboriginal community controlled health sector.”
A paediatric infectious diseases physician at the Murdoch Children’s Research Institute, Dr Linny Phuong, said other factors aside from low vaccination rates, like crowded housing, were also contributing to the outbreak.
“We really need to get better at ensuring that vulnerable populations are able to, you know, one, access healthcare, but two, that their social conditions are improved so that they have the same risks as the everyday Australian,” Dr Phuong told the ABC.
The free jabs will be for any Aboriginal and Torres Strait Islander adult who hasn’t had a dose in the last 10 years. (ABC News: Xavier Martin)
As the NSW government watches the spread of the disease in other states, it has sought to get on the front foot, announcing a targeted vaccination program, with free vaccines sent to Aboriginal medical services and GPs across the state.
The free jabs will be for any Aboriginal and Torres Strait Islander adult who hasn’t had a dose in the last 10 years.
“The community is reminded to check their vaccination status with their local GP, healthcare provider, or Aboriginal Medical Service, who can arrange vaccination,” A NSW Health spokesperson said.
Under the National Immunisation Program, diphtheria vaccines are already free if you are under 20 years of age, pregnant or a refugee or humanitarian entrant.
A booster is recommended for teenagers between 11 and 13 and adults at age 50 and 65 if their last dose was more than 10 years ago.
For those living in or travelling to higher-risk areas, a booster every five years is recommended.
