An Edmonton elementary school student with a compromised immune system has been diagnosed with a rare and potentially deadly diphtheria infection yet again.
Edmonton Public Schools sent home a letter to families of Evansdale School students, alerting them to a confirmed case of diphtheria. This is the same north Edmonton school where, in 2017, a student was confirmed to have the disease.
Rebecca Shewchuk’s 11-year-old son, Draven, was the student who had diphtheria last school year, and on Monday, Shewchuk confirmed he had become infected again.
Shewchuk said Draven is up to date on all of his vaccinations. She doesn’t know how her son contracted the disease again but says he has battled severe eczema since he was five months old, and that makes him more susceptible to certain illnesses.
In both cases, she said the infection was diagnosed after he developed open sores that were not healing. Draven was swabbed and the infection was confirmed. Shewchuk said he is now on antibiotics and in quarantine. She said the rest of the family is also under restrictions until their swabs come back.
What is diphtheria?
Diphtheria is a serious bacterial infection that causes inflammation in the upper respiratory tract, according to Alberta Health Services (AHS). It impacts the nose, throat and skin, and can cause severe breathing problems, heart failure, paralysis, neurological issues and even death.
About one in 10 people who get diphtheria die, according to AHS. Diphtheria can be easily spread through the air when an infected person coughs or sneezes, and also through direct skin-to-skin contact with an infected person.
The letter sent home from the school said the affected student had cutaneous diphtheria, which AHS says primarily causes skin infection. According to the Mayo Clinic, skin (cutaneous) diphtheria causes the typical pain, redness and swelling associated with other bacterial skin infections. Ulcers covered by a gray membrane also may develop in cutaneous diphtheria.
Severe eczema and social stigma
Shewchuk said Draven is in good spirits and she hopes someone can help find out where the diphtheria is coming from and why her son keeps getting infected.
She wants the public to be educated and hopes speaking out will help her son be connected with a specialist that could help treat the eczema, which causes red, itchy patches and inflammation on the skin. There is no cure for eczema.
Draven has been bullied, Shewchuk said, adding people make rude comments and assumptions based on her son’s appearance.
“People think he has scabies or that I abuse him, or that he needs to see a doctor or that he shouldn’t be in public,” Shewchuk said.
She said when he was younger, some parents wouldn’t let their kids play with Draven because they didn’t understand he has eczema and it is not contagious.
Evansdale School student Draven Shewchuk on his first day of Grade 6 in September 2018.
Shewchuk said Draven is in pain daily.
“His condition makes life difficult some days, as there are times it’s painful for him to walk and run and makes him miserable.”
She added he has missed school due to being hospitalized and his latest quarantine started on Friday.
“It will be 14 days [until] his next swab and then we need two consecutive negative swabs and then he can go back,” Shewchuk said, adding they are hoping Draven doesn’t miss his Grade 6 graduation.
AHS said it was contacting a small group of people who may have had close contact with the student as a precautionary measure, but no other cases have been identified.
Other students tested for infection
Lisa Connolly, whose son is in Shewchuk’s son’s class at Evansdale School, said her child stayed home from class on Monday as a precaution after being swabbed by AHS staff at the school last week.
Connolly said health-care workers, dressed in protective masks and gowns, arrived at the classroom to test the students on Friday.
“My son said he knew as soon as he saw the door,” she said. “He said when the door open and the lady walked in dressed like that, he knew because that’s what had happened in 2017 when they came to our house and did the same thing.”
She said she spent the weekend angry and frustrated, wondering how long officials knew a student was infected before testing the class.
“I’m just worried because it is a skin thing, so any of the children could become a carrier and not even know they’re a carrier, right?”
Alberta Health Services staff at Evansdale School in Edmonton on Friday, June 7, 2019.
Connolly’s main concern is how AHS will handle potential future diphtheria infections.
“The poor little guy that is sick — is this going to continuously happen? That would be my next question and they had no answer for that, because they couldn’t answer it for me.”
Diphtheria symptoms and treatment
Diphtheria symptoms include fever, sore throat, loss of appetite and feeling unwell. Severe disease can cause extreme neck swelling. Life-threatening complications include upper-airway obstruction.
Before antibiotics were available, diphtheria was a common illness in young children. Today, the disease is not only treatable, but also preventable through immunizations.
In Alberta, diphtheria vaccine is offered, free of charge, through Alberta’s publicly funded immunization program.
Dr. Chris Sikora, a medical officer of health with AHS, said Alberta sees about one to two cases of diphtheria per year.
“It is vaccine preventable. We have a very safe, very effective vaccine,” Sikora said.
“Thankfully, we do have fairly high immunization rates. But we always take this as an opportunity to remind parents that immunization is a good, safe and effective intervention for themselves and their kids.”
AHS says for children, adequate immunization is three doses of diphtheria-containing vaccine before one year of age, and booster doses at 18 months and between four to six years of age.
Children will also be offered a dose of diphtheria-containing vaccine in Grade 9 at school during routine scheduled immunization rounds. For adults, a booster dose of diphtheria-containing vaccine is recommended at 10 year intervals after the Grade 9 dose.
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