Skip to content
1887

Abstract

In the European region, diphtheria is now rarely suspected in patients presenting with upper respiratory tract symptoms. is the underestimated zoonosis that is replacing infections in industrialized countries, but extensive human and animal prevalence studies are lacking. The range of hosts that can act as reservoirs for is very broad, companion pets currently being the main source of human infection. We report a case of macrolide-resistant infection with no apparent zoonotic transmission and outline the efforts required for the public and zooprophylactic management of these cases. We describe the main critical issues to be addressed to comprehensively tackle this zoonosis in the future.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.0.000898.v3
2024-11-22
2026-03-06

Metrics

Loading full text...

Full text loading...

/deliver/fulltext/acmi/6/11/acmi000898.v3.html?itemId=/content/journal/acmi/10.1099/acmi.0.000898.v3&mimeType=html&fmt=ahah

References

  1. Sharma NC, Efstratiou A, Mokrousov I, Mutreja A, Das B et al. Diphtheria. Nat Rev Dis Primers 2019; 5:81 [View Article] [PubMed]
    [Google Scholar]
  2. Badell E, Alharazi A, Criscuolo A, Almoayed KAA, Lefrancq N et al. Ongoing diphtheria outbreak in Yemen: a cross-sectional and genomic epidemiology study. Lancet Microbe 2021; 2:e386–e396 [View Article] [PubMed]
    [Google Scholar]
  3. Polonsky JA, Ivey M, Mazhar MKA, Rahman Z, le Polain de Waroux O et al. Epidemiological, clinical, and public health response characteristics of a large outbreak of diphtheria among the Rohingya population in Cox’s Bazar, Bangladesh, 2017 to 2019: a retrospective study. PLoS Med 2021; 18:e1003587 [View Article] [PubMed]
    [Google Scholar]
  4. Adegboye OA, Alele FO, Pak A, Castellanos ME, Abdullahi MAS et al. A resurgence and re-emergence of diphtheria in Nigeria, 2023. Ther Adv Infect Dis 2023; 10:20499361231161936 [View Article] [PubMed]
    [Google Scholar]
  5. European centre for disease prevention and control (ECDC) Diphtheria - Annual Epidemiological Report; 2022 https://www.ecdc.europa.eu/sites/default/files/documents/DIPH_AER_2022_Report.pdf
  6. Wagner KS, White JM, Neal S, Crowcroft NS, Kuprevičiene N et al. Screening for Corynebacterium diphtheriae and Corynebacterium ulcerans in patients with upper respiratory tract infections 2007-2008: a multicentre European study. Clin Microbiol Infect 2011; 17:519–525 [View Article] [PubMed]
    [Google Scholar]
  7. Gower CM, Scobie A, Fry NK, Litt DJ, Cameron JC et al. The changing epidemiology of diphtheria in the United Kingdom, 2009 to 2017. Euro Surveill 2020; 25:1900462 [View Article] [PubMed]
    [Google Scholar]
  8. Martini H, Soetens O, Litt D, Fry NK, Detemmerman L et al. Diphtheria in Belgium: 2010-2017. J Med Microbiol 2019; 68:1517–1525 [View Article] [PubMed]
    [Google Scholar]
  9. Bonmarin I, Guiso N, Le Flèche-Matéos A, Patey O, Patrick ADG et al. Diphtheria: a zoonotic disease in France?. Vaccine 2009; 27:4196–4200 [View Article] [PubMed]
    [Google Scholar]
  10. Yamamoto A, Hifumi T, Ato M, Iwaki M, Senoh M et al. Clinical characteristics of Corynebacterium ulcerans infection, Japan. Emerg Infect Dis 2023; 29:1505–1515 [View Article]
    [Google Scholar]
  11. Otshudiema JO, Acosta AM, Cassiday PK, Hadler SC, Hariri S et al. Respiratory illness caused by Corynebacterium diphtheriae and C. ulcerans, and use of diphtheria antitoxin in the United States, 1996-2018. Clin Infect Dis 2021; 73:e2799–e2806 [View Article] [PubMed]
    [Google Scholar]
  12. Hillan A, Gibbs T, Weaire-Buchanan G, Brown T, Pang S et al. Zoonotic transmission of diphtheria toxin-producing Corynebacterium ulcerans. Zoo Public Health 2024; 71:157–169 [View Article] [PubMed]
    [Google Scholar]
  13. Konrad R, Hörmansdorfer S, Sing A. Possible human-to-human transmission of toxigenic Corynebacterium ulcerans. Clin Microbiol Infect 2015; 21:768–771 [View Article] [PubMed]
    [Google Scholar]
  14. Hacker E, Antunes CA, Mattos-Guaraldi AL, Burkovski A, Tauch A. Corynebacterium ulcerans, an emerging human pathogen. Future Microbiol 2016; 11:1191–1208 [View Article] [PubMed]
    [Google Scholar]
  15. Berger A, Badell E, Åhman J, Matuschek E, Zidane N et al. Corynebacterium diphtheriae and Corynebacterium ulcerans: development of EUCAST methods and generation of data on which to determine breakpoints. J Antimicrob Chemother 2024; 79:968–976 [View Article] [PubMed]
    [Google Scholar]
  16. Berbers G, van Gageldonk P, Kassteele J van de, Wiedermann U, Desombere I et al. Circulation of pertussis and poor protection against diphtheria among middle-aged adults in 18 European countries. Nat Commun 2021; 12:2871 [View Article] [PubMed]
    [Google Scholar]
  17. Wagner A, Jasinska J, Schmid D, Kundi M, Wiedermann U. Lack of seroprotection against diphtheria in the Austrian population. Euro Surveill 2022; 28:2300206 [View Article] [PubMed]
    [Google Scholar]
  18. von Hunolstein C, Rota MC, Alfarone G, Ricci ML, Salmaso S. Diphtheria antibody levels in the Italian population. Eur J Clin Microbiol Infect Dis 2000; 19:433–437 [View Article]
    [Google Scholar]
  19. Gao H, Lau EHY, Cowling BJ. Waning immunity after receipt of pertussis, diphtheria, tetanus, and polio-related vaccines: a systematic review and meta-analysis. J Infect Dis 2022; 225:557–566 [View Article] [PubMed]
    [Google Scholar]
  20. Möller J, Kraner M, Sonnewald U, Sangal V, Tittlbach H et al. Proteomics of diphtheria toxoid vaccines reveals multiple proteins that are immunogenic and may contribute to protection of humans against Corynebacterium diphtheriae. Vaccine 2019; 37:3061–3070 [View Article] [PubMed]
    [Google Scholar]
  21. Meinel DM, Margos G, Konrad R, Krebs S, Blum H et al. Next generation sequencing analysis of nine Corynebacterium ulcerans isolates reveals zoonotic transmission and a novel putative diphtheria toxin-encoding pathogenicity island. Genome Med 2014; 6: [View Article]
    [Google Scholar]
  22. Otsuji K, Fukuda K, Ogawa M, Saito M. Mutation and diversity of diphtheria toxin in Corynebacterium ulcerans. Emerg Infect Dis 2019; 25:2122–2123 [View Article] [PubMed]
    [Google Scholar]
  23. Mancini F, Monaco M, Pataracchia M, von Hunolstein C, Pantosti A et al. Identification and molecular discrimination of toxigenic and nontoxigenic diphtheria Corynebacterium strains by combined real-time polymerase chain reaction assays. Diagn Microbiol Infect Dis 2012; 73:111–120 [View Article] [PubMed]
    [Google Scholar]
  24. Konrad R, Berger A, Huber I, Boschert V, Hörmansdorfer S et al. Matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) mass spectrometry as a tool for rapid diagnosis of potentially toxigenic Corynebacterium species in the laboratory management of diphtheria-associated bacteria. Euro Surveill 2010; 15:19699 [View Article] [PubMed]
    [Google Scholar]
/content/journal/acmi/10.1099/acmi.0.000898.v3
Loading
/content/journal/acmi/10.1099/acmi.0.000898.v3
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An error occurred
Approval was partially successful, following selected items could not be processed due to error