Fading vintage map of Europe with subtle bacterial cells, symbolizing the re-emergence of diphtheria.

Diphtheria's Silent Return: What You Need to Know About This Preventable Threat

Avery Sinclair in Health & Wellness December 2025 • 4 min read.

"Cases are re-emerging in Europe, affecting travelers and migrant populations. Are you protected?"

Diphtheria, a bacterial infection primarily affecting the respiratory system, was once a major cause of childhood illness and death worldwide. Thanks to widespread vaccination programs, it had become relatively rare in many developed countries. However, recent years have seen a concerning re-emergence of diphtheria in Europe, prompting a closer look at the factors driving this trend and the steps individuals can take to protect themselves.

Recent research highlights that while Europe had seen a decline in cases, with 53 cases reported between 2000 and 2009, 2015 alone saw 36 cases. This uptick underscores the need for increased vigilance and awareness among healthcare providers and the public alike. The rise is particularly noted among vulnerable populations, such as migrants and travelers returning from regions where diphtheria is more prevalent.

This article explores the key findings of a recent study examining the re-emergence of Corynebacterium diphtheriae, the bacterium responsible for diphtheria. We'll delve into the specific cases identified in the research, discuss the risk factors contributing to the spread of the disease, and, most importantly, provide actionable information on how to safeguard your health through vaccination and awareness.

Who's at Risk and Why?

Fading vintage map of Europe with subtle bacterial cells, symbolizing the re-emergence of diphtheria.

The study pinpoints two distinct groups as being particularly vulnerable to diphtheria: travelers and migrant populations. For travelers, especially those visiting regions with lower vaccination rates or less developed healthcare systems, the risk of exposure is elevated. This risk is further compounded by waning immunity in adults who may not have received booster shots.

Migrant populations, often living in crowded conditions with limited access to healthcare and vaccination programs, also face a higher risk. Incomplete vaccination histories and potential exposure in their countries of origin contribute to this vulnerability.

Travelers: Risk increases when visiting regions with low vaccination rates.
Migrant Populations: Overcrowding and incomplete vaccination records increase risk.
Elderly: Seroprotection decreases with age; boosters are essential.

The research emphasizes that cutaneous diphtheria, a skin infection caused by C. diphtheriae, can act as a reservoir for the bacterium, potentially leading to outbreaks of both cutaneous and respiratory forms of the disease. Moreover, co-infections with other bacteria, such as Staphylococcus aureus, can complicate diagnosis and treatment, highlighting the need for thorough testing using techniques like MALDI-TOF.

Protecting Yourself and Your Community

The re-emergence of diphtheria serves as a critical reminder of the importance of vaccination. Maintaining high vaccination coverage rates within communities is essential to prevent outbreaks and protect those most vulnerable.

If you're planning international travel, consult with your healthcare provider to ensure you're up-to-date on all recommended vaccinations, including diphtheria. For individuals who have recently migrated to Europe, it's crucial to seek medical attention and verify vaccination status. Booster doses are also highly recommended, especially for elderly to maintain immunity.

By increasing awareness, promoting vaccination, and improving access to healthcare for all populations, we can collectively combat the resurgence of diphtheria and safeguard public health. Public health officials are urged to update and widely disseminate guidelines, including for managing asymptomatic carriers, to prevent further spread.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.medmal.2018.12.001, Alternate LINK

Title: Re-Emergence Of Corynebacterium Diphtheriae

Subject: Infectious Diseases

Journal: Médecine et Maladies Infectieuses

Publisher: Elsevier BV

Authors: C. Scheifer, C. Rolland-Debord, E. Badell, F. Reibel, A. Aubry, A. Perignon, O. Patey, S. Brisse, E. Caumes

Published: 2019-09-01

Everything You Need To Know

Why is diphtheria making a comeback in Europe?

Diphtheria is re-emerging in Europe due to a combination of factors. Travelers visiting regions with lower vaccination rates and less developed healthcare systems are at increased risk because they may be exposed to Corynebacterium diphtheriae. Migrant populations, often living in crowded conditions with limited access to healthcare and vaccination programs, are also more vulnerable. Waning immunity in adults who haven't received booster shots further contributes to the problem.

Who is most at risk of contracting diphtheria, according to recent research?

The research indicates that travelers visiting regions with lower vaccination rates, and migrant populations living in crowded conditions with limited healthcare access are particularly vulnerable to contracting diphtheria. Additionally, elderly individuals experiencing decreased seroprotection due to age also face a higher risk. Cutaneous diphtheria can also act as a reservoir for the bacterium, potentially leading to outbreaks of both cutaneous and respiratory forms of the disease.

What steps can be taken to protect against diphtheria and reduce its spread?

Vaccination is a critical measure to protect against diphtheria. Maintaining high vaccination coverage rates within communities is essential to prevent outbreaks, particularly protecting the most vulnerable populations. Booster shots are important for adults to maintain immunity. The research also highlights the need for thorough testing for co-infections with other bacteria like Staphylococcus aureus, which can complicate diagnosis and treatment.

What is cutaneous diphtheria, and why is it significant in the context of diphtheria outbreaks?

Cutaneous diphtheria, a skin infection caused by Corynebacterium diphtheriae, serves as a reservoir for the bacterium. This means it can lead to outbreaks of both cutaneous and respiratory forms of the disease. The skin infection can harbor the bacteria and facilitate its transmission, increasing the risk of wider spread within communities. Controlling cutaneous diphtheria is therefore essential in preventing broader outbreaks.

Why is thorough testing using techniques like MALDI-TOF important in diagnosing diphtheria?

MALDI-TOF is used for thorough testing because co-infections with other bacteria, such as Staphylococcus aureus, can complicate the diagnosis and treatment of diphtheria. By using MALDI-TOF, healthcare providers can accurately identify the specific bacteria present, enabling them to provide the most effective treatment. This is particularly important given the potential for cutaneous diphtheria to act as a reservoir and the vulnerability of specific populations.