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Those at highest risk for developing diphtheria are persons who travel to countries where diphtheria is endemic and where sanitation is inadequate. Those regions include Eastern Europe, the Middle East, Asia, the South Pacific, and countries including Haiti, the Dominican Republic, and Venezuela.
Diphtheria is extremely rare in U.S. and other developed countries with good sanitation. Between 1996 and 2017, there were 13 reported cases of respiratory diphtheria in the U.S. – five confirmed through culture and eight considered probable, as culturing was not completed. Of those cases, one fatality occurred in an international traveler who returned from an area where diphtheria is considered endemic. In 2019, there were two cases of non-respiratory diphtheria (infection of the bloodstream, cutaneous) reported, with both cases associated with travel to diphtheria-endemic regions.
Cutaneous diphtheria, a form of diphtheria that affects the skin, is commonly seen among persons who live in tropical climates or among persons experiencing homelessness.
IMPORTANT NOTE: NVIC encourages you to become fully informed about Diphtheria and the Diphtheria vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.