We report a diphtheria outbreak mostly among children (median 12 years; range 4-26 years) of a religious minority in urban India. Case-fatality rate (15%, 19/124) was higher among unimmunized patients (relative risk 4.1, 95% CI 1.5-11.7). We recommend mandating and integrating immunization into school health programs to prevent reemergence.
Keywords: Corynebacterium diphtheriae; adolescents; bacteria; children; diphtheria; disease outbreaks; evidence-based recommendations; immunization; vaccine-preventable diseases; vaccines; zoonoses.