Prevention of diphtheria in Germany: Yesterday, today, tomorrow - An overview

The year 2000 was the first without the registration of any cases of diphtheria in Germany. However, serologic protection against diphtheria amongst the population is very low, especially among young and middle-aged adults, where over 50% are not or only minimally protected. In a review of the diphtheria cases of the last 7 years (n = 18), three factors were associated with the disease: adult age (14 cases between 18 and 50 years of age), travelling (in 14 of 18 cases travelling to or from endemic areas played a role) and occupational exposure (suspected in 6 of 18 cases). In Germany, the official guidelines which suggest a booster vaccination every ten years are followed very insufficiently. Should vaccination habits fail to improve, population immunity will further decrease and a resurgence of diphtheria will become more likely. Measures for future preventive activities are being discussed.