Overview

• Since January 2023, EU/EEA health authorities have documented 234 diphtheria cases, exceeding the pre-2020 annual average of 21.
• Most recent infections have occurred among people experiencing homelessness, recently arrived migrants and individuals who use or inject drugs.
• The ECDC’s Rapid Risk Assessment rates the threat to the general population as very low while categorising risk as moderate for vulnerable groups.
• Clinical presentations include cutaneous ulcers and respiratory diphtheria marked by a grey-white throat membrane and “bull neck,” with a 5–10% fatality rate among unvaccinated patients.
• To interrupt transmission, the ECDC calls for enhanced symptom awareness, equitable booster access, strengthened surveillance and regular antitoxin stock assessments.