Important uncertainties remain regarding the role of coinfection, asymptomatic carriage, and the contribution of toxigenic Corynebacterium diphtheriae to clinical disease. This Letter to the Editor highlights several key unanswered questions and emphasises the need for a better understanding of this re-emerging infection to inform diagnosis, microbiological testing, clinical management, and public health responses.
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Gooding et al. (2026) studied this question.
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