Is diphtheria a forgotten disease?

Abstract

Diphtheria is a severe infectious disease that can be prevented by vaccination. In the past few decades, it has re-emerged in connection with reduced vaccination coverage in the countries affected by war or social unrest. During the past decade, the migrant crisis additionally influenced the reappearance of diphtheria, especially its cutaneous forms. On the other hand, in many countries, diphtheria is considered an eliminated infection, and over time attention paid to this disease has decreased, as has the level of knowledge about laboratory and clinical diagnostic methods. Suspicion of the cutaneous or respiratory forms of diphtheria potentially present in migrants who pass the so-called Balkan route initiated the establishment of an active surveillance system to be considered with the aim of early detection of potential cases, adequate sampling, laboratory testing, treatment and implementation of relevant measures regarding exposed contacts. The aim of this review article was to raise the level of awareness of physicians who may come into contact with diphtheria patients, as well as to revise the knowledge required for adequate laboratory confirmation of the diagnosis and supervision. The paper presents an overview of the current literature in this field, as well as recommendations for laboratory work and supervision.