Toxigenic diphtheria rarely detected amid rising cases of nontoxigenic Corynebacterium diphtheriae infections in Ontario, Canada, 2011–2023

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Observational analysis reveals rising nontoxigenic Corynebacterium diphtheriae cases in Ontario, indicating significant public health implications.

Toxigenic Corynebacterium diphtheriae infections were only 2.7% of cases from 2011 to 2023, while nontoxigenic infections surged.
Whole-genome sequencing indicated localized transmission with major genetic clusters among nontoxigenic strains.
Assessment of public health response involved 146 cases, predominantly of nontoxigenic C. diphtheriae from cutaneous sources.
Analysis underscores the need for healthcare professionals to distinguish toxigenic from nontoxigenic infections.

McTaggart et al. (2025) studied this question.

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Observational analysis reveals rising nontoxigenic Corynebacterium diphtheriae cases in Ontario, indicating significant public health implications.