Published: 06.10.05 Updated: 07.10.2005 09:09:30

Hans Blystad, Lars Blad, Johan Giesecke, Swedish Institute for Infectious Disease Control, Sweden, the Steering Group of the project Building a Network for Infections Disease Surveillance in the Baltic Sea Region


Diphtheria is a notifiable disease in all the countries of the region.


In the early 1990s, a sharp increase in reported cases of diphtheria was observed in the Baltic countries and Northwest Russia. This was attributed to a drop in the vaccination coverage and inadequate vaccination. In most of the countries in the eastern part of the region, the epidemic reached its peak around 1995 and massive vaccination campaigns have greatly improved the situation. However, in Latvia and some of the Northwest Russia regions, notably Saint Petersburg, Leningrad Oblast and Republic of Kareliya, a second wave of increase in diphtheria incidence has been observed during the last few years.

During the early 1990s, very few cases of diphtheria were reported in Germany and 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.

High-risk groups

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

Prevention strategies

Efficient 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 is now generally high in the entire region. Vaccination of adults is important in the Baltic countries and Northwest Russia.