What is Diphtheria?

Diphtheria is a life-threatening infection of the upper respiratory tract caused by Corynebacterium diphtheria. It also affects internal organs and/or the skin.In Europe, both diphtheria and tetanus are rare in­fections due to universal childhood vaccination and regular boosters [ECDC 2013].

Diphtheria is an example of a disease where main­taining high vaccination coverage through all age groups is necessary despite the rarity of the disease today. ECDC recommends high routine and booster diphtheria vaccination coverage to prevent future outbreaks in the EU [ECDC 2013].

Risk groups for contracting diphtheria include women and older people:

  • Women may have closer contact with pets (which can harbour bacteria) and be less likely to have routine military vaccinations than men [ECDC 2013]
  • Adults aged 45–65 have reduced immunity due to the absence of booster doses [ECDC 2013]
  • Older people may never have been properly vaccinated against diphtheria; in Spain less than half of those born before 1975 were properly vaccinated [ECDC 2013]


In 2010, there were only 14 confirmed cases of diphtheria in the EU (Figure 6).

  • Cases occurred in France, Germany, Latvia and the UK
  • Most cases were women aged 45 years and older [ECDC 2013]
  • Although rare in the EU, diphtheria remains prevalent in some of the countries of the former Soviet Union (Latvia, Russia and Ukraine).
  • Sporadic cases reported from Europe may have been imported from countries where diphtheria is still endemic [European Diphtheria Surveillance Network]
  • There is a risk of new outbreaks if population im­munity is suboptimal [ECDC 2013]

Summary of key points

  • Diphtheria is a life-threatening infection which mainly affects women and older people
  • Only sporadic cases in Europe
  • To prevent future outbreaks, there is a need for vaccination through all age groups