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In September 2018, a child who had returned from Somalia to Germany presented with cutaneous diphtheria by toxigenic biovar The child’s sibling had superinfected insect bites harbouring also toxigenic . 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 in Germany since the 1980s.


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