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Volume 18, Number 2—February 2012


Diphtheria in the Postepidemic Period, Europe, 2000–2009

Karen S. WagnerComments to Author , Joanne M. White, Irina Lucenko, David Mercer, Natasha S. Crowcroft, Shona Neal, Androulla Efstratiou, and on behalf of the Diphtheria Surveillance Network
Author affiliations: Health Protection Agency, London, UK (K.S. Wagner, J.M. White, N.S. Crowcroft, S. Neal, A. Efstratiou); State Agency Infectology Center of Latvia, Riga, Latvia (I. Lucenko); World Health Organization Regional Office for Europe, Copenhagen, Denmark (D. Mercer); Public Health Ontario, Toronto, Ontario, Canada (N.S. Crowcroft); University of Toronto Dalla Lana School of Public Health, Toronto (N.S. Crowcroft)

Main Article

Table 4

Vaccination status of case-patients and clinical manifestations of toxigenic Corynebacterium diphtheriae and C. ulcerans infections and epidemiologically linked cases without laboratory confirmation, DIPNET cases excluding Latvia, Europe, 2000–2009*

Vaccination status Classic respiratory diphtheria (with membrane) Mild respiratory diphtheria/severe pharyngitis Cutaneous Other Asymptomatic Not known Total
Full 4 17 2 1† 2 0 26
Partial 5 3 7 0 0 0 15
Unvaccinated 14 3 4 0 1 0 22
Not known 15 10 15‡ 12 11¶ 64
Total 38 33 28 2 15 11 127

*DIPNET, Diphtheria Surveillance Network. p = 0.001 by test for trend (vaccination status and disease severity).
†Bacterial endocarditis (C. diphtheriae, fully vaccinated)
‡One cutaneous case-patient also had a sore throat.
§Isolation from blood (C. ulcerans, vaccination status not known).
¶Includes 2 case-patients infected with C. diphtheriae who died and are assumed to have respiratory symptoms without specific details available.

Main Article

1Additional members of the Diphtheria Surveillance Network who contributed data are listed in Technical Appendix 1.