Dr. Steph Williams

So that's known.

We also know that we have pretty good vaccine coverage, which prevents the most severe form of disease and remains the most effective preventive intervention.

So it prevents the effects that the toxin from the bacteria causes, which is the most severe form of respiratory diphtheria, the membrane that can form across the throat and cause an airway obstruction.

And vaccination remains very effective at preventing the toxin-mediated disease, but it doesn't prevent the transmission or carriage with this bacteria, which does live in us as humans as a reservoirs.

At this stage, there does not seem to be any evidence that the bug has changed or it's behaving any differently.

There is more research that could be done here, but certainly talking to our laboratory experts and committees, that that does not seem to be a factor in the current outbreak.

And, you know, from the data we have, you know, at the national level, it's pretty hard to say.

And I guess the answer is I'm not really sure.

One thing to do with what has changed is

there's a high level of awareness and testing.

So as this outbreak took off, there was more case and contact management taking place and significant vaccination efforts and really mobilised efforts in affected communities.

So we know that in responding to individual cases, we will always find more cases.

But you asked earlier about whether there was sort of undetection, and there has been raised as a possibility of undetected cutaneous transmission.

So the skin version of the bacteria may have been spreading without us seeing it.

But the other thing I just think is important to add to that context is, you know, in talking with colleagues at NACCHO, the National Aboriginal Community Controlled Health Organisation,

They're very quick to point out that the message about being tested for sore throats and skin wounds in Aboriginal communities is very consistent.

So the clinical practice does not appear to be a reason why now we're seeing more cases of diphtheria.

And certainly an encouragement to always be looking and testing for sore throats and skin infections, yeah.

Look, I mean, the genetic analysis helps us understand that they have the same genetic footprint.

And that's really described well in these CDC reports.