Diphtheria: forgotten, but not gone.

Area of Science:

• Infectious Diseases
• Vaccinology
• Public Health

Background:

• Diphtheria is an acute, highly infectious, vaccine-preventable disease caused by Corynebacterium diphtheriae.
• It can manifest as respiratory, cutaneous, or asymptomatic infections, with pharyngeal/tonsillar sites being most common.
• Complications include cardiac and neurological toxicity due to toxin dissemination.

Observation:

• Routine childhood vaccination dramatically reduced diphtheria incidence in industrialized nations.
• However, recent cases in Australia highlight the pathogen's continued threat.
• The effectiveness of treatment, particularly diphtheria antitoxin, is inversely related to illness duration.

Findings:

• Diphtheria was a leading infectious cause of death in Australia pre-vaccination.
• Recent diphtheria cases and positive cultures in Australia indicate a need for increased vigilance.
• Immunity levels in school leavers and adults may be insufficient.

Implications:

• Public health strategies must focus on boosting immunity in adolescents and adults.
• Travellers to endemic regions require full immunization.
• Clinicians and policymakers must prioritize diphtheria vaccination for all age groups, including adults and travelers.