The global incidence of diphtheria remained steady during 2007–2011 after a steady decline of over 95 % from 1980 to 2006. This was largely due to a resurgence of the disease in India, which alone accounted for 71–83 % of the total cases reported worldwide.

Case presentation:

This article describes the identification of an outbreak of diphtheria in two very remote villages of northern Karnataka in South India in May 2011 and detection of further cases in as many as seven nearby villages in the 6 months that followed, which resulted in at least three deaths. The ineffectiveness of the Universal Immunization Programme in its present form in reaching the remote villages is highlighted, and one case of diphtheria with a non‐toxigenic strain of , which is very rare in India and has the potential to upset eradication strategies, is documented.


This article should provide a wake‐up call for the health administrators for restructuring and strengthening immunization strategies and programmes.

Keyword(s): children , diphtheria and outbreak
  • This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/).

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