Urgent summer holiday warning as cases of highly contagious ‘bull-neck' infection spread rapidly across Europe
A total of 234 diphtheria cases have been reported in European countries since January 2023, according to the
1
Diphtheria is a contagious and serious infection that can turn fatal if not treated
Credit: Getty
Diphtheria can be a serious illness that sometimes turns fatal, especially in children, if it's not treated quickly.
It causes a thick grey-white coating at the back of the throat, nose and tongue, and fever.
More severe cases can lead to a characteristic swollen neck and throat, or "bull neck." This can make it hard for the person to breathe properly.
If the disease affects the skin, it can cause pus-filled blisters on the legs, feet and hands, as well as large ulcers surrounded by red, sore-looking skin.
Diphtheria is thought to be rare in Europe and the UK, with cases falling steadily since the 1950s after the introduction of vaccines.
Between 2009 and 2020, an average of 21 cases were reported each year in Europe.
But "a marked shift occurred in 2022", as 320 cases - two of them probable - were detected in European countries, the ECDC
"Similar
trends
" were also reported in the UK, according to the health watchdog.
Most read in Health
"Ten European countries were affected by this outbreak, with Germany,
The outbreak was "mainly linked to groups of migrants who had recently arrived in Europe" and been exposed to diphtheria on their journey, it added.
What is Rat Lungworm (Angiostrongylus) Disease-
Since then, the number of diphtheria cases in Europe has "consistently declined", but the ECDC warned that infections were still being reported - especially among vulnerable people.
A total of 165 cases were flagged to the ECDC in 2023, 56 in 2024 and 13 so far into 2025.
"Published data and recent personal communications indicate that
after the 2022 outbreak,
Corynebacterium diphtheriae
continued to circulate in at least five EU/EEA countries and in Switzerland," the health watchdog said.
"A significant proportion of these cases has been among people more vulnerable to diphtheria," it added.
These include people experiencing homelessness, people living, working or volunteering in transitional housing centres, migrants, and those who use and inject drugs.
Bruno
Ciancio, head of ECDC's unit for directly-transmitted and vaccine-preventable diseases, said: "The fact that we see diphtheria infections acquired by vulnerable populations in the EU/EEA indicates ongoing unnoticed transmission in the community.
"This is a cause for concern, and calls for more intense efforts to address barriers to vaccination among these vulnerable groups.
"Effective vaccination programmes have helped to almost eliminate diphtheria, but this also means that healthcare workers may be less likely to recognise the symptoms.
"Increasing awareness of symptoms, quick diagnosis and prompt public health action are essential."
Diphtheria symptoms
Symptoms usually start two to five days after becoming infected.
Symptoms of diphtheria include:
A thick grey-white coating that may cover the back of your throat, nose and tongue
A high temperature
Sore throat
Swollen glands in your neck
Difficulty breathing and swallowing
In countries with poor hygiene, infection of the skin (cutaneous diphtheria) is more common.
If it's cutaneous diphtheria, it can cause:
Pus-filled blisters on your legs, feet and hands
Large ulcers surrounded by red, sore-looking skin
You should get urgent medical help if you have the above symptoms.
Source:
NHS
The ECDC noted the risk of catching diphtheria remained low for the general population, thanks to high vaccination coverage in most European countries.
But for vulnerable people, it upped the risk to moderate.
"There could be sporadic cases among groups more vulnerable to infection and pockets of unvaccinated individuals," the health watchdog said.
It added that Germany in particular had "reported an increase in diphtheria cases with respiratory presentation, raising concerns about more severe clinical manifestations, and possibly wider community spread".
In places with high vaccines coverage, most diphtheria infections don't cause symptoms or are mild.
But respiratory diphtheria - when the infections affects the nose and throat - can kill up to 10 per cent of its victims, the ECDC said.
Diphtheria is mostly spread by coughs, sneezing or close contact.
You can, however, also get it from sharing items such as cups, clothing or bedding with an infected person.
In the UK, babies and children have been routinely vaccinated against diphtheria since the 1940s.
Read more on the Irish Sun
A case of the highly contagious disease was spotted in a UK primary school in 2023.
In 2022, 87 people in England were infected with the disease. This fell to 27 in 2023.
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Irish Examiner
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'Our records show Ireland has accepted 14 patients thus far, though we are aware of the intention to receive more patients.' They added that WHO continues to advocate for increased evacuations. They said: 'But it depends on EU Member States and other host countries accepting more patients, and ongoing logistical and security challenges to ensure the safe movement and transportation of patients. 'WHO has put in place the necessary logistical arrangements within Gaza to increase the number of medical evacuations should there be an increase in offers from receiving countries and security clearance from the Israeli government. 'WHO regional director for Europe, Dr Hans Kluge, has been strongly advocating for member states to scale up medical evacuations in line with humanitarian and health principles.' Hamdi Al-Najjar is visited by his brother, Ali Al-Najjar, and two nieces, Samah Al-Najjar (L) and Sahar Al-Najjar (R), while in the intensive care unit at Nasser Hospital in Khan Yunis, Gaza, after an Israeli airstrike hit his home (Image: Hani Alshaer/Anadolu via Getty Images) The Department of Health in Ireland said it is 'not aware of any request made by the WHO or other agencies for Ireland to take more patients than originally agreed'. They said the Ministry of Health in Gaza has the primary role of selecting patients for medical evacuation overseas. The statement added: 'WHO is present on the ground in Gaza and is coordinating evacuations of patients through Egypt and other third countries to EU participating Member States. 'Ireland opts into this response on a case-by-case basis for each child who requires treatment, subject to the available capacity. 'The patients to be selected for treatment in Ireland must be minors, ie under 17 years of age. 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Palestinians walk during the evacuation of the Jabalia refugee camp and the Sheikh Radwan and Abu Iskandar neighborhoods in the northern Gaza Strip amid the ongoing war in the Palestinian territories between Israel and Hamas (Image: Mahmoud Issa/Quds Net News via ZUMA Press Wire) They added: 'The current focus of the Department and all relevant authorities is to prepare for the next medical evacuation of paediatric patients from Gaza and accompanying family members through Egypt. We know from experience of two previous medical evacuations that preparation and planning is critical to the success of these complex medical evacuations.' 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