Diphtheria epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Diphtheria is found worldwide but is rare in the United States. Diphtheria causes significant illness and death in developing countries where vaccination coverage is low.
Epidemiology and Demographics
- Diphtheria is found worldwide; countries with endemic diphtheria are shown in Table below.
- During the 1990s, large epidemics occurred in the newly independent states of the former Soviet Union.
- More recently in the Americas, diphtheria outbreaks have occurred in Haiti and the Dominican Republic.
- Diphtheria is uncommon in industrialized countries because of longstanding routine use of DTP (diphtheria and tetanus toxoids and pertussis vaccine).
- Diphtheria is rare in the United States; the last case occurred in an elderly traveler returning from Haiti in 2003. Diphtheria causes significant illness and death in developing countries where vaccination coverage is low.
- By 1998, according to Red Cross estimates, there were as many as 200,000 cases in the Commonwealth of Independent States, with 5,000 deaths.
- This was so great an increase that diphtheria was cited in the Guinness Book of World Records as "most resurgent disease".
- Diphtheria is rare in the United States; the last case occurred in an elderly traveler returning from Haiti in 2003. Diphtheria causes significant illness and death in developing countries where vaccination coverage is low.
Table 3-01. Countries with endemic diphtheria
| REGION | COUNTRIES |
| Africa | Algeria, Angola, Egypt, Eritrea, Ethiopia, Guinea, Niger, Nigeria, Sudan, Zambia, and other sub- Saharan countries |
| America | Bolivia, Brazil, Colombia, Dominican Republic, Ecuador, Haiti, and Paraguay |
| Asia/South Pacific | Bangladesh, Bhutan, Burma (Myanmar), Cambodia, China, India, Indonesia, Laos, Malaysia, Mongolia, Nepal, Pakistan, Papua New Guinea, Philippines, Thailand, and Vietnam |
| Middle East | Afghanistan, Iran, Iraq, Saudi Arabia, Syria, Turkey, and Yemen |
| Europe | Albania, Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan |