{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:27:21Z","timestamp":1773923241900,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,2,12]],"date-time":"2013-02-12T00:00:00Z","timestamp":1360627200000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Diphtheria is an acute, highly infectious, vaccine\u2010preventable and previously endemic disease whose etiologic agent is <jats:italic><jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>orynebacterium diphtheriae<\/jats:italic>. Diphtheria may manifest as an upper respiratory tract infection, a cutaneous infection or as an asymptomatic carrier state. The most common sites of infection are the pharynx and the tonsils, with common clinical manifestations that include sore throat, malaise, cervical lymphadenopathy and low\u2010grade fever. Absorption and dissemination of <jats:italic><jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>.\u2009diphtheriae<\/jats:italic> from the respiratory tract can cause disseminated infection and may lead to cardiac or neurological toxicity. The cornerstone of treatment for diphtheria is diphtheria antitoxin. Early treatment is critical as the degree of protection is inversely proportional to the duration of the illness before its administration. Routine childhood vaccination virtually eliminated diphtheria in most industrialised countries. However, in the pre\u2010vaccination era, diphtheria was the most common infectious cause of death in <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ustralia. A case of diphtheria in Brisbane in <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>pril 2011 and two recent positive cultures in regional Victoria underscore the need for heightened awareness of <jats:italic><jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>.\u2009diphtheriae<\/jats:italic> as an important pathogen. In order to prevent the re\u2010emergence of diphtheria in <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ustralia, public health measures are required to increase immunity in early school leavers and the adult population, and to ensure that travellers to endemic regions are fully immunised. Health policy\u2010makers and clinicians alike should not underestimate the importance of primary vaccination and booster vaccination against diphtheria among healthy adults and travellers.<\/jats:p>","DOI":"10.1111\/imj.12049","type":"journal-article","created":{"date-parts":[[2013,2,13]],"date-time":"2013-02-13T01:22:28Z","timestamp":1360718548000},"page":"206-210","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Diphtheria: forgotten, but not gone"],"prefix":"10.1111","volume":"43","author":[{"given":"N. R.","family":"Adler","sequence":"first","affiliation":[{"name":"Geelong Clinical School School of Medicine Deakin University  Geelong Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Mahony","sequence":"additional","affiliation":[{"name":"Austin Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. 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