Diphtheria Resurgence Factors 

Decline in Vaccination Rates 

Insufficient vaccination coverage, due to factors like vaccine hesitancy, lack of access to healthcare, or breakdowns in healthcare infrastructure, can lead to outbreaks of vaccine-preventable diseases like diphtheria. 

Migration and Travel 

Movement of people across borders can facilitate the spread of infectious diseases, including diphtheria, to regions where vaccination coverage may be inadequate. 

Antibiotic Resistance 

Diphtheria treatment relies on antibiotics. The emergence of antibiotic-resistant strains of the diphtheria bacterium could complicate efforts to control outbreaks. 

Limited Surveillance and Diagnosis 

In some regions, limited healthcare resources may hinder effective surveillance and timely diagnosis of diphtheria cases, allowing outbreaks to go undetected or untreated. 

Social and Economic Factors 

Socioeconomic disparities, poverty, and inadequate access to healthcare can contribute to the persistence of diphtheria in certain populations.