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Diphtheria outbreaks are resurging globally, affecting both children and adults. Maintaining high vaccination coverage and booster doses is crucial to control this serious infectious disease.

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Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Diphtheria was a major childhood illness, primarily affecting children under 15 before widespread vaccination.
  • Widespread diphtheria toxoid immunization in industrialized nations led to decreased incidence and fewer circulating toxigenic Corynebacterium diphtheriae.
  • Reduced natural boosting of antibody levels in adults has created immunity gaps, contributing to diphtheria's resurgence in some regions.

Purpose of the Study:

  • To analyze the resurgence of diphtheria in both industrialized and developing countries.
  • To highlight the changing epidemiology of diphtheria, with increased adult cases.
  • To emphasize the need for sustained high vaccination coverage and booster doses.

Main Methods:

  • Review of historical and recent diphtheria incidence data from industrialized and developing countries.
  • Analysis of vaccination coverage trends and their impact on disease prevalence.
  • Examination of outbreak characteristics, including age distribution and case fatality rates.

Main Results:

  • Diphtheria has re-emerged, particularly in European countries since 1990, with a significant proportion of cases in adults.
  • Developing countries with increasing vaccination coverage have also reported outbreaks, often with high case fatality rates and complications.
  • Outbreaks occur across all age groups, indicating challenges in maintaining population immunity.

Conclusions:

  • Achieving at least 90% coverage with three doses of diphtheria toxoid in infants is a global priority.
  • Maintaining immunity through booster doses is essential in countries that have successfully controlled diphtheria.
  • Sustained public health efforts are necessary to prevent and control diphtheria resurgence.