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Euro Surveill. 2019 Jan;24(2). doi: 10.2807/1560-7917.ES.2019.24.2.1800683.

Whole genome sequencing suggests transmission of Corynebacterium diphtheriae-caused cutaneous diphtheria in two siblings, Germany, 2018.

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These authors contributed equally to this paper.
Bavarian Health and Food Safety Authority, Oberschleißheim, Germany.
National Consiliary Laboratory for Diphtheria, Oberschleißheim, Germany.
Division of Pediatric Infectious Diseases, Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
Department of Health and Environment, Munich, Germany.
Max von Pettenkofer-Institute, Ludwig-Maximilians-University Munich, Munich, Germany.


In September 2018, a child who had returned from Somalia to Germany presented with cutaneous diphtheria by toxigenic Corynebacterium diphtheriae biovar mitis. The child's sibling had superinfected insect bites harbouring also toxigenic C. diphtheriae. Next generation sequencing (NGS) revealed the same strain in both patients suggesting very recent human-to-human transmission. Epidemiological and NGS data suggest that the two cutaneous diphtheria cases constitute the first outbreak by toxigenic C. diphtheriae in Germany since the 1980s.


Corynebacterium diphtheriae; MLST; WGS; diphtheria; outbreak; toxigenic; typing

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