Editing Diphtheria (section)

==History==
In 1613, [[Health in Spain|Spain]] experienced an epidemic of diphtheria, referred to as {{lang|es|El Año de los Garrotillos}} (The Year of Strangulations).<ref name=":0">{{cite journal|last=Laval|first=Enrique|title=El garotillo (Difteria) en España (Siglos XVI y XVII)|journal=Revista Chilena de Infectología|date=March 2006|volume=23|issue=1|pages=78–80|doi=10.4067/S0716-10182006000100012|pmid=16462970|doi-access=free}}</ref>

In 1705, the [[Mariana Islands]] experienced an epidemic of diphtheria and [[typhus]] simultaneously, reducing the population to about 5,000 people.<ref>{{cite book |last1=Rogers |first1=Robert F. |title=Destiny's Landfall: A History of Guam |date=June 30, 2011 |publisher=University of Hawai'i Press |location=Honolulu, Hawai'i |isbn=978-0-8248-3334-3 |page=72}}</ref>

In 1735, a diphtheria epidemic swept through [[New England]].<ref>{{cite journal|journal=[[Pediatrics (journal)|Pediatrics]]|year=1975|volume=55|pages=43|issue=1|title=On the Treatment of Diphtheria in 1735|url=http://pediatrics.aappublications.org/content/55/1/43|url-access=subscription|publisher= [[American Academy of Pediatrics]]|doi=10.1542/peds.55.1.43|s2cid=245183270}}</ref>

Before 1826, diphtheria was known by different names across the world. In [[England]], it was known as "Boulogne sore throat," as the illness had spread from [[France]]. In 1826, [[Pierre Bretonneau]] gave the disease the name ''diphthérite'' (from Greek διφθέρα, ''diphthera'' 'leather'), describing the appearance of pseudomembrane in the throat.<ref>Bretonneau, Pierre (1826) ''Des inflammations spéciales du tissu muqueux, et en particulier de la diphtérite, ou inflammation pelliculaire, connue sous le nom de croup, d'angine maligne, d'angine gangréneuse, etc.'' [Special inflammations of mucous tissue, and in particular diphtheria or skin inflammation, known by the name of croup, malignant throat infection, gangrenous throat infection, etc.] Paris, France:  Crevot.<br>
A condensed version of this work is available in:  P. Bretonneau (1826) [http://babel.hathitrust.org/cgi/pt?id=mdp.39015062233708;view=1up;seq=217 "Extrait du traité de la diphthérite, angine maligne, ou croup épidémique"] (Extract from the treatise on diphtheria, malignant throat infection, or epidemic croup), ''Archives générales de médecine'', series 1, 11 :  219–254.  From p. 230:  " … M. Bretonneau a cru convenable de l'appeler diphthérite, dérivé de ΔΙΦθΕΡΑ, … " ( … Mr. Bretonneau thought it appropriate to call it diphtheria, derived from ΔΙΦθΕΡΑ [diphthera], … )</ref><ref>{{cite web|title=Diphtheria|url=http://www.etymonline.com/index.php?term=diphtheria|work=Online Etymology Dictionary|access-date=29 November 2012|url-status=live|archive-url=https://web.archive.org/web/20130113162016/http://www.etymonline.com/index.php?term=diphtheria|archive-date=13 January 2013}}</ref>

In 1856, [[Victor Fourgeaud]] described an epidemic of diphtheria in [[Health in California|California]].<ref>{{cite book |last1=Fourgeaud |first1=Victor John |title=Diphtheritis: A Concise Historical and Critical Essay on the Late Epidemic Pseudo-membranous Sore Throat of California (1856-7) with a Few Remarks Illustrating the Diagnosis, Pathology and Treatment of the Disease |date=1858 |publisher=J. Anthony |oclc=11760038 |url=http://resource.nlm.nih.gov/101179231 }}{{pn|date=February 2024}}</ref>

In 1878, [[Princess Alice of the United Kingdom|Princess Alice]] ([[Queen Victoria]]'s second daughter) and her family became infected with diphtheria; Princess Alice and her four-year-old daughter, [[Princess Marie of Hesse and by Rhine (1874–1878)|Princess Marie]], both died.<ref>{{cite web|title=Diaries and Letters – Princess Alice of Hesse and by Rhine|url=http://www.alexanderpalace.org/palace/alicehessebio.html}}</ref>{{Self-published inline|date=November 2021|certain=y}}

In 1883, [[Edwin Klebs]] identified the bacterium causing diphtheria,<ref>Klebs, E. (1883) [https://books.google.com/books?id=bs0vAAAAIAAJ&pg=RA1-PA139 "III. Sitzung:  Ueber Diphtherie" (Third session:  On diphtheria), ''Verhandlungen des Congresses für innere Medicin. Zweiter Congress gehalten zu Wiesbaden, 18.-23. April 1883''] {{webarchive|url=https://web.archive.org/web/20160522005528/https://books.google.com/books?id=bs0vAAAAIAAJ&pg=RA1-PA139 |date=22 May 2016 }} (Proceedings of the Congress on Internal Medicine.  Second congress held at Wiesbaden, 18–23 April 1883), 2 : 139–154.</ref> and named it [[Corynebacterium diphtheriae|Klebs–Loeffler bacterium]]. The club shape of this bacterium helped Edwin to differentiate it from other bacteria. Over time, it has been called ''Microsporon diphtheriticum'', ''Bacillus diphtheriae'', and ''Mycobacterium diphtheriae''. Current nomenclature is ''Corynebacterium diphtheriae''.<ref>{{Cite web |title=Corynebacterium diphtheriae |url=https://www.ncbi.nlm.nih.gov/Taxonomy/Browser/wwwtax.cgi?mode=info&id=1717 |website=NCBI Taxonomy browser }}</ref>

In 1884, German [[bacteriologist]] [[Friedrich Loeffler]] became the first person to cultivate ''C.&nbsp;diphtheriae''.<ref>Loeffler, F. (1884) "Untersuchungen über die Bedeutung der Mikroorganismen für die Entstehung der Diphtherie, beim Menschen, bei der Taube und beim Kalbe" (Investigations into the significance of microorganisms in the development of diphtheria among humans, pigeons, and calves), ''Mitteilungen aus der Kaiserlichen Gesundheitsamte'' (Communications from the Imperial Office of Health), 2 :  421–499.</ref> He used [[Koch's postulates]] to prove association between ''C.&nbsp;diphtheriae'' and diphtheria. He also showed that the bacillus produces an exotoxin.{{citation needed|date=November 2017}}[[File:Diphtheria Immunisation Scheme, London, England, 1941 D3184.jpg|upright=1.3|thumb|left|A diphtheria immunisation scheme in London (1941)]]

In 1885, [[Joseph O'Dwyer|Joseph P. O'Dwyer]] introduced the O'Dwyer tube for laryngeal intubation in patients with an obstructed larynx. It soon replaced [[Tracheotomy|tracheostomy]] as the emergency diphtheric intubation method.<ref>{{cite journal|last=Gifford|first=Robert R.|s2cid=37108037|title=The O'Dwyer tube; development and use in laryngeal diphtheria|journal=Clin Pediatr (Phila)|date=March 1970|volume=9|issue=3|pages=179–185|doi=10.1177/000992287000900313|pmid=4905866}}</ref>

In 1888, [[Emile Roux]] and [[Alexandre Yersin]] showed that a substance produced by ''C.&nbsp;diphtheriae'' caused symptoms of diphtheria in animals.<ref>Roux, E. and Yersin, A. (December 1888)  [https://archive.org/stream/annalesdelinstit02inst#page/n686/mode/1up "Contribution à l'étude de la diphthérte"] {{webarchive|url=https://web.archive.org/web/20160315082939/https://archive.org/stream/annalesdelinstit02inst |date=15 March 2016 }} (Contribution to the study of diphtheria), ''Annales de l'Institute Pasteur'', 2 :  629–661.</ref><ref>{{cite book|last=Parish|first=Henry|title=A history of immunization|year=1965|publisher=E. & S. Livingstone|page=120}}</ref>

In 1890, [[Kitasato Shibasaburō|Shibasaburō Kitasato]] and [[Emil von Behring]] immunized guinea pigs with heat-treated diphtheria toxin.<ref>Behring, E. and Kitasato, S. (1890) [https://archiv.ub.uni-marburg.de/eb/2013/0164/ "Ueber das Zustandekommen der Diphtherie-Immunitat und der Tetanus-Immunitat bei Thieren"] {{webarchive|url=https://web.archive.org/web/20161220042358/https://archiv.ub.uni-marburg.de/eb/2013/0164/ |date=20 December 2016 }} (On the realization of diphtheria immunity and tetanus immunity among animals), ''Deutsche medizinsche Wochenschrift'', ''16'' : 1113–1114.</ref> They also immunized goats and horses in the same way, and showed that an "[[antitoxin]]" made from [[Serum (blood)|serum]] of immunized animals could cure the disease in non-immunized animals. Behring used this antitoxin (now known to consist of [[Antibody|antibodies]] that neutralize the toxin produced by ''C.&nbsp;diphtheriae'') for human trials in 1891, but they were unsuccessful. Successful treatment of human patients with horse-derived antitoxin began in 1894, after production and quantification of antitoxin had been optimized.<ref>{{Cite journal|last=Kaufmann|first=Stefan H. E.|date=8 March 2017|title=Remembering Emil von Behring: from Tetanus Treatment to Antibody Cooperation with Phagocytes|journal=mBio|language=en|volume=8|issue=1|pages=e00117–17|pmid=28246359|pmc=5347343|doi=10.1128/mBio.00117-17}}</ref><ref name=":1">{{Cite news|url=https://journals.lww.com/academicmedicine/Fulltext/2000/04000/Horses_and_the_Diphtheria_Antitoxin.22.aspx|title=Horses and the Diphtheria Antitoxin|date=April 2000|work=Academic Medicine|language=en-US}}</ref> In 1901, Von Behring won the first [[Nobel Prize in Physiology or Medicine|Nobel Prize in medicine]] for his work on diphtheria.<ref>Emil von Behring [https://www.nobelprize.org/nobel_prizes/medicine/laureates/1901/behring-lecture.html Serum Therapy in Therapeutics and Medical Science]. Nobel Lecture, 12 December 1901. nobelprize.org</ref>

In 1895, [[H. K. Mulford Company]] of [[Philadelphia]] started production and testing of diphtheria antitoxin in the United States.<ref>{{cite book|author=H. K. Mulford Company|title=Diphtheria Antitoxin|year=1903|publisher=The Company|url=https://books.google.com/books?id=hV_StgAACAAJ}}</ref> [[William Hallock Park|Park]] and [[Hermann Biggs|Biggs]] described the method for producing serum from horses for use in diphtheria treatment.{{citation needed|date=November 2017}}

In 1897, [[Paul Ehrlich]] developed a standardized unit of measure for diphtheria antitoxin. This was the first ever standardization of a biological product, and played an important role in future developmental work on sera and vaccines.<ref>{{Cite web |title=Difference Between Serums & Vaccines {{!}} What is - YTread |url=https://youtuberead.com/difference-between-serums-vaccines |access-date=2023-04-02 |website=youtuberead.com |language=en}}</ref>

In 1901, 10 of 11 inoculated [[St. Louis]] children died from contaminated diphtheria antitoxin. The horse from which the antitoxin was derived died of [[tetanus]]. This incident, coupled with a tetanus outbreak in [[Camden, New Jersey]],<ref>{{cite journal|title=The Tetanus Cases in Camden, N.J|journal=JAMA|date=7 December 1901|volume=XXXVII|issue=23|pages=1539–1540|doi=10.1001/jama.1901.02470490037010}}</ref> played an important part in initiating federal regulation of biologic products.<ref>{{cite journal|last=Lilienfeld|first=David E.|s2cid=30767303|title=The first pharmacoepidemiologic investigations: national drug safety policy in the United States, 1901–1902|journal=Perspect Biol Med|date=Spring 2008|volume=51|issue=2|pages=188–198|doi=10.1353/pbm.0.0010|pmid=18453724}}</ref>

On 7 January 1904, [[Ruth Cleveland]] died of diphtheria at the age of 12 years in [[Princeton, New Jersey]]. Ruth was the eldest daughter of former [[President of the United States|President]] [[Grover Cleveland]] and the former [[First Lady of the United States|First Lady]], [[Frances Folsom]].{{citation needed|date=June 2022}}

In 1905, Franklin Royer, from Philadelphia's Municipal Hospital, published a paper urging timely treatment for diphtheria and adequate doses of antitoxin.<ref>{{cite journal|last=Royer|first=Franklin|title=The Antitoxin Treatment of Diphtheria, with a Plea for Rational Dosage in Treatment and in Immunizing|journal = The Therapeutic Gazette|year=1905}}</ref> In 1906, [[Clemens Pirquet]] and [[Béla Schick]] described [[serum sickness]] in children receiving large quantities of horse-derived antitoxin.<ref name="pmid11231202">{{cite journal |author=Jackson R |s2cid=7001068 |title=Serum sickness |journal=J Cutan Med Surg |volume=4 |issue=4 |pages=223–5 |date=October 2000 |pmid=11231202 |doi= 10.1177/120347540000400411}}</ref>

Between 1910 and 1911, Béla Schick developed the [[Schick test]] to detect pre-existing immunity to diphtheria in an exposed person. Only those who had not been exposed to diphtheria were vaccinated. A massive, five-year campaign was coordinated by Dr. Schick. As a part of the campaign, 85 million pieces of literature were distributed by the [[Metropolitan Life Insurance Company]], with an appeal to parents to "Save your child from diphtheria." A vaccine was developed in the next decade, and deaths began declining significantly in 1924.<ref>{{Cite web| url=http://www.healthsentinel.com/graphs.php?id=14&event=graphs_print_list_item | title=United States mortality rate from measles, scarlet fever, typhoid, whooping cough, and diphtheria from 1900–1965 |access-date=30 June 2008 |publisher=HealthSentinel.com |archive-url = https://web.archive.org/web/20080514014018/http://www.healthsentinel.com/graphs.php |archive-date = 14 May 2008}}</ref>

In 1919, in [[Dallas|Dallas, Texas]], 10 children were killed and 60 others made seriously ill by toxic antitoxin which had passed the tests of the [[New York State Department of Health|New York State Health Department]]. The manufacturer of the antitoxin, the [[Merck Sharp & Dohme|Mulford Company of Philadelphia]], paid damages in every case.<ref>{{cite book|last=Wilson|first=Graham|title=The Hazards of Immunization|year=2002|publisher=Continuum International Publishing Group, Limited, 2002|isbn=9780485263190|pages=20}}</ref>

During the 1920s, an annual estimate of 100,000 to 200,000 diphtheria cases and 13,000 to 15,000 deaths occurred in the United States.<ref name="Pinkbook"/> Children represented a large majority of these cases and fatalities. One of the most infamous outbreaks of diphtheria occurred in 1925, in [[Nome, Alaska]]; the [[1925 serum run to Nome|"Great Race of Mercy"]] to deliver diphtheria antitoxin is now celebrated by the [[Iditarod Trail Sled Dog Race]].<ref>{{Cite web|url=https://www.cdc.gov/about/24-7/savinglives/diphtheria/index.html|title=Iditarod: Celebrating the "Great Race of Mercy" to Stop Diphtheria Outbreak in Alaska {{!}} About {{!}} CDC|date=11 July 2018|website=www.cdc.gov|language=en-us|access-date=5 March 2019}}</ref>

In 1926, Alexander Thomas Glenny increased the effectiveness of diphtheria [[toxoid]] (a modified version of the toxin used for vaccination) by treating it with aluminum salts.<ref>{{cite web|url=http://www.historyofvaccines.org/content/timelines/diseases-and-vaccines |title=Timeline |at=1926 — Glenny Develops Adjuvant |work=History of Vaccines |access-date=28 October 2013 |url-status=live |archive-url=https://web.archive.org/web/20140701081956/http://www.historyofvaccines.org/content/timelines/diseases-and-vaccines |archive-date=1 July 2014}}</ref> Vaccination with toxoid was not widely used until the early 1930s.<ref>[https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/dip.pdf Immunology and Vaccine-Preventable Diseases – Pink Book – Diphtheria], CDC</ref> In 1939, Dr. [[Nora Wattie]], who was the [[Principal Medical Officer]] (Maternity and Child Welfare) of Glasgow between 1934– 1964,<ref>{{Cite web |date=March 2021 |title=Nora Isabel Wattie |url=https://mathshistory.st-andrews.ac.uk/Extras/Wattie_Nora/ |url-status=live |archive-url=https://archive.today/20230903042427/https://mathshistory.st-andrews.ac.uk/Extras/Wattie_Nora/ |archive-date=3 September 2023 |access-date=2 September 2023 |website=MacTutor |publication-place=[[University of St Andrews]]}}</ref> introduced immunisation clinics across [[Glasgow]], and promoted mother and child health education, resulting in virtual eradication of the infection in the city.<ref>{{Cite journal|last1=Mackie|first1=Elizabeth M|last2=Scott Wilson|first2=T.|date=12 November 1994|title=Obituary N.I.Wattie|journal=British Medical Journal|volume=309|pages=1297}}</ref>

Widespread vaccination pushed cases in the United States down from 4.4 per 100,000 inhabitants in 1932 to 2.0 in 1937. In [[Nazi Germany]], where authorities preferred treatment and isolation over vaccination (until about 1939–1941), cases rose over the same period from 6.1 to 9.6 per 100,000 inhabitants.<ref>{{Cite journal|last1=Baten|first1=Joerg|last2=Wagner|date=2003|title=Autarky, Market Disintegration, and Health: The Mortality and Nutritional Crisis in Nazi Germany 1933–37|journal=Economics and Human Biology |volume=1-1 |issue=1 |pages=1–28 |doi=10.1016/S1570-677X(02)00002-3 |pmid=15463961 |s2cid=36431705 |url=https://www.cesifo.org/DocDL/cesifo_wp800.pdf}}</ref>

Between June 1942 and February 1943, 714 cases of diphtheria were recorded at [[Sham Shui Po Barracks]], resulting in 112 deaths because the [[Imperial Japanese Army]] did not release supplies of anti-diphtheria serum.<ref>{{cite book |last=Felton|first=Mark|author-link=Mark Felton|date=2009|title=The Real Tenko: Extraordinary True Stories of Women Prisoners of the Japanese|url= |location=Great Britain|publisher=Pen & Sword Military|page=41 |isbn=9781848845503}}</ref>

In 1943, diphtheria outbreaks accompanied war and disruption in [[Europe in World War II|Europe]]. The 1 million cases in Europe resulted in 50,000 deaths.{{citation needed|date=March 2017}}

During 1948 in [[Kyoto]], 68 of 606 children died after diphtheria immunization due to improper manufacture of aluminum phosphate toxoid.<ref>{{cite book |editor1-first=Kathleen R. |editor1-last=Stratton |editor2-first=Cynthia J. |editor2-last=Howe |editor3-first=Richard B. |editor3-last=Johnston |chapter=Diphtheria and Tetanus Toxoids |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK236292/ |title=Adverse Events Associated with Childhood Vaccines: Evidence Bearing on Causality |date=1994 |publisher=National Academies Press |isbn=978-0-309-04895-8 }}</ref>

In 1974, the [[World Health Organization]] included [[DPT vaccine]] in their [[Expanded Programme on Immunization]] for [[Developing country|developing countries]].<ref>{{cite web | title = Immunization, Vaccines and Biologicals | publisher = World Health Organization | url = https://www.who.int/immunization/programmes_systems/en/ | archive-url = https://web.archive.org/web/20131208072315/http://www.who.int/immunization/programmes_systems/en/ | url-status = dead | archive-date = 8 December 2013 | access-date = 10 May 2020}}</ref><ref>{{cite journal |last1=Keja |first1=Ko |last2=Chan |first2=Carole |last3=Hayden |first3=Gregory |last4=Henderson |first4=Ralph H. |title=Expanded Programme on Immunization |journal=World Health Statistics Quarterly |date=1988 |volume=41 |issue=2 |pages=59–63 |pmid=3176515 |hdl=10665/49253 }}</ref>

In 1975, an outbreak of cutaneous diphtheria in [[Seattle|Seattle, Washington]], was reported.<ref>{{cite journal|last=Harnisch|first=JP|author2=Tronca E |author3=Nolan CM |author4=Turck M |author5=Holmes KK |title=Diphtheria among alcoholic urban adults. A decade of experience in Seattle|journal=Annals of Internal Medicine|date=1 July 1989|volume=111|issue=1|pages=71–82|pmid=2472081|doi=10.7326/0003-4819-111-1-71}}</ref>

After the breakup of the former [[Soviet Union]] in 1991, vaccination rates in its constituent countries fell so low that an explosion of diphtheria cases occurred. In 1991, 2,000 cases of diphtheria occurred in the USSR. Between 1991 and 1998, as many as 200,000 cases were reported in the [[Commonwealth of Independent States]], and resulted in 5,000 deaths.<ref name=":0" /> In 1994, the [[Russia|Russian Federation]] had 39,703 diphtheria cases. By contrast, in 1990, only 1,211 cases were reported.<ref>{{cite journal|doi=10.1086/315567|pmid=10657219|title=Contraindications to Vaccination in the Russian Federation|journal=The Journal of Infectious Diseases|volume=181|pages=S228–31|year=2000|last1=Tatochenko|first1=Vladimir|last2=Mitjushin|first2=I. L.|doi-access=free}}
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In early May 2010, a case of diphtheria was diagnosed in [[Port-au-Prince]], [[Health in Haiti|Haiti]], after the devastating [[2010 Haiti earthquake]]. The 15-year-old male patient died while workers searched for antitoxin.<ref>{{Cite web | url=http://ac360.blogs.cnn.com/2010/05/10/video-diphtheria-epidemic-threatens-haiti/ | title=CNN's Anderson Cooper talks with Sean Penn and Dr. Sanjay Gupta about the threat of diphtheria in Haiti | date=10 May 2010 | work=CNN. | url-status=dead | archive-url=https://web.archive.org/web/20161220045251/http://ac360.blogs.cnn.com/2010/05/10/video-diphtheria-epidemic-threatens-haiti/ | archive-date=20 December 2016 | df=dmy-all }}</ref>

In 2013, three children died of diphtheria in [[Hyderabad, India]].<ref>{{Cite news | url=http://www.thehindu.com/news/cities/Hyderabad/three-kids-die-of-diphtheria/article5065637.ece?homepage=true | title=Three kids die of diphtheria | date=28 August 2013 | work=The Hindu | url-status=live | archive-url=https://web.archive.org/web/20161220221203/http://www.thehindu.com/news/cities/Hyderabad/three-kids-die-of-diphtheria/article5065637.ece?homepage=true | archive-date=20 December 2016 | df=dmy-all }}</ref>

In early June 2015, a case of diphtheria was diagnosed at [[Vall d'Hebron University Hospital]] in [[Barcelona]], [[Spain]]. The six-year-old child who died of the illness had not been previously vaccinated due to parental [[vaccine controversies|opposition to vaccination]].<ref>{{Cite web|title = Parents of diphtheria-stricken boy feel "tricked" by anti-vaccination groups|url = http://elpais.com/elpais/2015/06/05/inenglish/1433512717_575817.html|work = El Pais|date = 5 June 2015|url-status = live|archive-url = https://web.archive.org/web/20150607000140/http://elpais.com/elpais/2015/06/05/inenglish/1433512717_575817.html|archive-date = 7 June 2015|df = dmy-all}}</ref> It was the first case of diphtheria in the country since 1986, as reported by the Spanish daily newspaper ''[[El Mundo (Spain)|El Mundo]],''<ref>{{Cite web|title = Primer caso de difteria en España en casi 30 años|url = http://www.elmundo.es/salud/2015/06/02/556dbc3d268e3e16598b4589.html|work = El Mundo|date = 2 June 2015|url-status = live|archive-url = https://web.archive.org/web/20150602181425/http://www.elmundo.es/salud/2015/06/02/556dbc3d268e3e16598b4589.html|archive-date = 2 June 2015|df = dmy-all}}</ref> or from 1998, as reported by the WHO.<ref>{{Cite web|title = WHO – Diphtheria reported cases|url = http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tsincidencediphtheria.html|access-date = 11 June 2015|url-status = live|archive-url = https://web.archive.org/web/20150612235540/http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tsincidencediphtheria.html|archive-date = 12 June 2015|df = dmy-all}}</ref>

In March 2016, a three-year-old girl died of diphtheria in the University Hospital of [[Antwerp]], [[Health in Belgium|Belgium]].<ref>{{Cite web|url=http://www.standaard.be/cnt/dmf20160317_02188083|title=Meisje (3) overlijdt aan difterie in ziekenhuis|website=De Standaard|date=17 March 2016|url-status=live|archive-url=https://web.archive.org/web/20160319045227/http://www.standaard.be/cnt/dmf20160317_02188083|archive-date=19 March 2016}}</ref>

In June 2016, a three-year-old, five-year-old, and seven-year-old girl died of diphtheria in [[Kedah]], [[Malacca]], and [[Sabah]], [[Health in Malaysia|Malaysia]].<ref>{{Cite web|url=http://www.thestar.com.my/news/nation/2016/06/21/story/|title=Malacca Health Dept works to contain diptheria after seven-year-old dies|date=21 June 2016|author=Murali, R.S.N.|work=thestar.com.my|url-status=live|archive-url=https://web.archive.org/web/20160624034554/http://www.thestar.com.my/news/nation/2016/06/21/story/|archive-date=24 June 2016}}</ref>

In January 2017, more than 300 cases were recorded in [[Health in Venezuela|Venezuela]].<ref>{{Cite news|url=https://www.reuters.com/article/us-venezuela-health-idUSKBN185260|title=Infant mortality and malaria soar in Venezuela, according to government data|date=9 May 2017|work=Reuters|access-date=3 June 2017|url-status=live|archive-url=https://web.archive.org/web/20170524223813/http://www.reuters.com/article/us-venezuela-health-idUSKBN185260|archive-date=24 May 2017}}</ref><ref>{{Cite web|url=http://www.healthmap.org/site/diseasedaily/article/diphtheria-reemerges-venezuela-remains-brink-economic-collapse-22117|title=Diphtheria Reemerges as Venezuela Remains on the Brink of Economic Collapse {{!}} HealthMap|website=www.healthmap.org|access-date=3 June 2017|url-status=live|archive-url=https://web.archive.org/web/20170712034357/http://www.healthmap.org/site/diseasedaily/article/diphtheria-reemerges-venezuela-remains-brink-economic-collapse-22117|archive-date=12 July 2017}}</ref>

In 2017, outbreaks occurred in a [[Rohingya refugees in Bangladesh|Rohingya refugee camp in Bangladesh]], and amongst children unvaccinated due to the [[Yemeni Civil War (2014–present)|Yemeni Civil War]].<ref>[https://www.npr.org/sections/goatsandsoda/2017/12/08/569462246/diphtheria-why-is-it-back-and-what-exactly-is-it Diphtheria: What Exactly Is It ... And Why Is It Back?]</ref>

In November and December 2017, an outbreak of diphtheria occurred in [[Indonesia]], with more than 600 cases found and 38 fatalities.<ref>{{Cite news|url=https://news.detik.com/berita/d-3774591/idi-38-anak-meninggal-karena-difteri|title=IDI: 38 Anak Meninggal karena Difteri|last=Nugraha|first=Indra Komara|work=detiknews|access-date=18 December 2017}}</ref>

In November 2019, two cases of diphtheria occurred in the [[Lothian]] area of [[Health in Scotland|Scotland]].<ref>{{Cite news|url=https://www.bbc.co.uk/news/uk-scotland-edinburgh-east-fife-50358872|title=Two cases of deadly diphtheria detected in Lothian area|date=9 November 2019|author=BBC|work=BBC News}}</ref> Additionally, in November 2019, an unvaccinated 8-year-old boy died of diphtheria in [[Athens]], [[Health in Greece|Greece]].<ref>{{Cite web|url=https://www.amea-care.gr/%ce%bf%ce%ba%cf%84%ce%ac%cf%87%cf%81%ce%bf%ce%bd%ce%bf%cf%82-%cf%80%ce%ad%ce%b8%ce%b1%ce%bd%ce%b5-%ce%b1%cf%80%cf%8c-%ce%b4%ce%b9%cf%86%ce%b8%ce%b5%cf%81%ce%af%cf%84%ce%b9%ce%b4%ce%b1-%cf%83%cf%84/|title=Οκτάχρονος πέθανε από διφθερίτιδα στην Αθήνα - Δεν είχε εμβολιαστεί|date=2019-11-28|website=ΑμεΑ Care|language=el|access-date=2019-11-28}}</ref>

In July 2022, two cases of diphtheria occurred in northern [[New South Wales]], [[Health in Australia|Australia]].<ref>{{Cite news|url=https://www.theguardian.com/australia-news/2022/jul/03/toddler-diagnosed-with-first-case-of-diphtheria-of-the-throat-in-nsw-in-a-century|title=Two children diagnosed with first cases of diphtheria of the throat in NSW this century|access-date=21 July 2022}}</ref>

In October 2022, there was an outbreak of diphtheria at the former [[RAF Manston|Manston airfield]], a former [[Ministry of Defence (United Kingdom)|Ministry of Defence]] (MoD) site in [[Kent]], [[Health in England|England]], which had been converted to an [[Asylum seekers in the United Kingdom|asylum seeker processing centre]]. The capacity of the processing centre was 1,000 people, although about 3,000 were living at the site, with some accommodated in tents. The [[Home Office]], the government department responsible for asylum seekers, refused to confirm the number of cases.<ref>{{Cite web |last=Taylor |first=Diane |date=20 October 2022 |title=Diphtheria outbreak confirmed at asylum seeker centre in Kent |url=https://www.theguardian.com/science/2022/oct/20/diphtheria-outbreak-confirmed-at-asylum-seeker-centre-in-kent |archive-url=https://web.archive.org/web/20221020114017/https://www.theguardian.com/science/2022/oct/20/diphtheria-outbreak-confirmed-at-asylum-seeker-centre-in-kent |archive-date=20 October 2022 |access-date=21 October 2022 |website=The Guardian |language=en}}</ref>

In December 2023 there was an outbreak at a school in [[Luton]], in the [[United Kingdom]]. [[UK Health Security Agency]] (UKHSA) issued a statement saying specialists have been providing public health support following confirmation of the diphtheria case at a primary school in Luton. The agency said it is working closely with local and national partners "to ensure all necessary public health measures are implemented" following the discovery of the new case. The statement added: "We have conducted a risk assessment and close contacts of the case have been identified and where appropriate, vaccination and advice will be given to prevent the spread of the infection."<ref>{{cite web |url=https://www.manchestereveningnews.co.uk/news/health/ukhsa-issues-statement-case-rare-28285751 |title=UKHSA issues statement as case of rare infectious disease confirmed at UK primary school |website=The Manchester Evening News |language=en |date=13 December 2023 |access-date=14 December 2023}}</ref>