Published: 09.02.05 Updated: 09.02.2005 18:13:28


Diphtheria is a notifiable disease in the entire region. Estonia, Norway and Sweden report laboratory confirmed cases, cases with typical clinical picture without laboratory confirmation and cases epidemiologically linked to a laboratory confirmed case. Denmark, Lithuania and Northwest Russia report both laboratory confirmed cases and cases with typical clinical picture without laboratory confirmation. Finland and Iceland report only laboratory confirmed cases.

Figure 22. Number of cases of diphteria notified in 2003 per 100 000 population (1).


In the early 1990s, a sharp increase in reported cases of diphtheria was observed in the Baltic countries and Northwest Russia. This increase was caused by a drop in the vaccination coverage. In most of the countries in the eastern part of the region, the epidemic reached its peak around 1995 and massive vaccination campaigns in the most heavily affected regions have greatly improved the situation. However, in Latvia and some of the Northwest Russia regions, notably Saint Petersburg, Leningrad oblast and Republic of Karelia, a second wave of increase in diphtheria incidence has been observed. In the period 1993-2003, a total of 1359 cases of diphtheria with 101 deaths were reported in Latvia. Most cases occurred in unvaccinated adults (16).

During the early 1990s, very few cases of diphtheria were reported in the Nordic countries.   The few cases reported were mainly imported from Southeast-Asia. Since 1995, Finland has reported eight cases and Norway one case of diphtheria where the patients had direct or indirect contact with persons from Northwest Russia.

Non-immune children and adults, especially alcoholics and homeless people, are at the highest risk of contracting diphtheria in the region.


Effective vaccination remains the mainstay of the preventive efforts. Diphtheria vaccine is a part of the national immunisation programmes in all the countries in the region. The vaccination coverage in children is now generally high in the entire region. Vaccination of adults is important in the Baltic countries and Northwest Russia.