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This review aims to summarize the historical and current state of diphtheria epidemiology and vaccination efforts.

May 28, 2026

Clinical progress note: Diphtheria

Key Points

This review aims to summarize the historical and current state of diphtheria epidemiology and vaccination efforts.
Reviewed epidemiologic data from 1922 to 2025.
Examined vaccination impacts in the US and globally.
Highlighted historical outbreaks and discussed clinical features and treatment.
Dramatic reduction in diphtheria cases achieved through vaccination efforts.
Diphtheria persists in areas with low vaccine coverage and weakened healthcare systems.
A notable epidemic occurred in the former Soviet republics during the 1990s, underscoring the need for robust immunization.

Abstract

Diphtheria, caused by toxigenic Corynebacterium diphtheriae, was once a leading cause of childhood morbidity and mortality worldwide. The development of diphtheria antitoxin and toxoid vaccination resulted in dramatic reductions in global disease burden. Despite significant success, diphtheria persists in regions with low immunization coverage, fragile healthcare infrastructure, and waning adult immunity. This review summarizes epidemiologic trends from 1922 to 2025, examines the impact of vaccination efforts in the United States and worldwide, highlights historical outbreaks including the 1990s epidemic in the former Soviet republics, and discusses clinical features, diagnostics, treatment, and current preparedness. Continued robust immunization programs remain essential for sustained control.

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Clinical progress note: Diphtheria

Key Points

Abstract

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