{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T20:02:36Z","timestamp":1791576156981,"version":"4.3.4"},"reference-count":52,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2010,8,9]],"date-time":"2010-08-09T00:00:00Z","timestamp":1281312000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:p>\n                    Diphtheria is an uncommon disease in the UK due to an effective immunization programme; consequently when cases do arise, there can be delays in diagnosis and case-fatality rates remain high. We reviewed 102 patients with infections caused by toxigenic corynebacteria (an average of four per year) reported in the UK between 1986 and 2008: 42\n                    <jats:italic>Corynebacterium diphtheriae<\/jats:italic>\n                    , 59\n                    <jats:italic>C. ulcerans<\/jats:italic>\n                    and one\n                    <jats:italic>C. pseudotuberculosis<\/jats:italic>\n                    , as well as 23 asymptomatic carriers. Five fatalities were reported, all in unvaccinated patients. The major risk factor for\n                    <jats:italic>C. diphtheriae<\/jats:italic>\n                    infection continued to be travel to an endemic country.\n                    <jats:italic>C. ulcerans<\/jats:italic>\n                    infections became more common than\n                    <jats:italic>C. diphtheriae<\/jats:italic>\n                    infections in the UK; they were associated with contact with companion animals. The occurrence of indigenous severe\n                    <jats:italic>C. ulcerans<\/jats:italic>\n                    infections and imported\n                    <jats:italic>C. diphtheriae<\/jats:italic>\n                    cases highlights the need to maintain UK routine vaccination coverage at the 95% level in the UK, as recommended by the World Health Organization.\n                  <\/jats:p>","DOI":"10.1017\/s0950268810001895","type":"journal-article","created":{"date-parts":[[2010,8,9]],"date-time":"2010-08-09T10:12:34Z","timestamp":1281348754000},"page":"1519-1530","source":"Crossref","is-referenced-by-count":149,"title":["Diphtheria in the United Kingdom, 1986\u20132008: the increasing role of\n                    <i>Corynebacterium ulcerans<\/i>"],"prefix":"10.1017","volume":"138","author":[{"given":"K. S.","family":"WAGNER","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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S.","family":"CROWCROFT","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"DE MARTIN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"MANN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"EFSTRATIOU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2010,8,9]]},"reference":[{"key":"S0950268810001895_ref046","first-page":"41","article-title":"Infective endocarditis due to Corynebacterium diphtheriae: report of a case and review of the literature","volume":"148","author":"Love","year":"1981","journal-title":"Johns Hopkins Medical Journal"},{"key":"S0950268810001895_ref016","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.72.852.619"},{"key":"S0950268810001895_ref015","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-4453(95)92260-1"},{"key":"S0950268810001895_ref008","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100120985"},{"key":"S0950268810001895_ref005","first-page":"242","article-title":"Control of diphtheria: guidance for consultants in communicable disease control","volume":"2","author":"Bonnet","year":"1999","journal-title":"Communicable Disease and Public Health"},{"key":"S0950268810001895_ref042","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.67.4.433"},{"key":"S0950268810001895_ref030","doi-asserted-by":"publisher","DOI":"10.1051\/vetres:2005056"},{"key":"S0950268810001895_ref027","first-page":"4","article-title":"A case of diphtheria caused by toxigenic Corynebacterium ulcerans","volume":"16","year":"2006","journal-title":"Communicable Disease Report. 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