Humans are the primary reservoir for C. diphtheriae. Sources of infection include carriers who have recovered from an infection, new cases not exhibiting symptoms, people with active disease, and contaminated articles. Corynebacterium diphtheriae can colonize people who have been immunized, making them asymptomatic carriers. The bacterium is carried in chronic skin ulcers ("cutaneous diphtheria") in some indigent populations. Typically, the organisms are spread by air and acquired by inhalation.

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