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Respiratory and cutaneous diphtheria are no longer endemic in the U.S., thanks to widespread childhood immunization with diphtheria toxoid–containing vaccine (DTaP), boosted often by administration of antitetanus prophylaxis given as tetanus-diphtheria-pertussis (Tdap) vaccines.
Four cases of cutaneous diphtheria due to infection with toxin-producing Corynebacterium diphtheriae were reported to the CDC between September 2015 and March 2018 in patients from Minnesota, Washington, and New Mexico who had recently returned from Somalia, Ethiopia, and the Philippines. Diphtheria was not suspected clinically; although coryneform organisms were noted in the exudate from the lesions, the etiologic diagnosis was not made until specimens were tested b…