Diphtheria – get the facts

Diphtheria is a serious bacterial infection. Learn the causes, symptoms, and when to get a vaccine to prevent it.


What are the symptoms of diphtheria?

Causes and how it spreads

When to see a doctor 

What’s the diagnosis and treatment?

 Vaccination  

Diphtheria is a bacterial infection of the throat, nose, and sometimes skin. It’s more common in certain parts of the world. It can be spread through coughs and sneezes, and close contact with an infected person. It can be deadly if it isn’t treated quickly – but a vaccine can prevent it.


Diphtheria is a serious illness that can be life-threatening. It’s caused by a type of bacteria called ‘Corynebacterium diphtheriae’.

The condition is rare in the US, UK, and Western Europe, thanks to routine vaccination. But it’s still common in some parts of the world.

Diphtheria affects your nose and throat, and sometimes your skin. It’s easily spread from one person to another (it's contagious) through droplets from the mouth or nose, and contaminated surfaces.

Symptoms include a sore throat and fever, and it can lead to serious problems, such as breathing difficulties and [heart failure](https://www.livehealthily.com/health-library/conditions/heart-failure).

If you think you could have diphtheria you should get urgent medical attention.

Early diagnosis and treatment reduce the risk of complications, but vaccination offers the best protection.


## What are the symptoms of diphtheria?

Symptoms usually appear 2 to 5 days after you’re infected, and can include:

- a thick gray-white coating on your throat, tongue, tonsils, and in your nose
- fever – 38ºC/100.4ºF or above
- sore throat and hoarseness (raspy/strained voice)
- fast breathing, or trouble breathing or swallowing
- swollen glands in your neck
- tiredness (fatigue) and weakness
- discharge from your nose.

A rare form known as ‘cutaneous’ diphtheria affects the skin. This is more common in tropical places, or in overcrowded living conditions. 

Symptoms include:

- painful, pus-filled blisters
- large ulcers with red, inflamed edges.


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## Causes and how it spreads

The bacterium that causes diphtheria usually infects your throat. It releases a poison (toxin) that damages the tissues of your throat and nose. If untreated, the toxin can cause serious problems in other parts of your body, such as your heart.

Diphtheria is very contagious, and it can be spread through:

- coughing, sneezing or spitting – these release droplets that contain bacteria
- close contact with an infected person
- sharing utensils, cups, or personal items with an infected person
- touching something that has bacteria on it.

### Who’s at risk?

Diphtheria is rare in countries with [routine vaccination](https://www.livehealthily.com/health-library/conditions/diphtheria#vaccination), such as the US and UK. But it’s more common in developing countries where vaccination levels are low. 

You’re at higher risk of getting diphtheria if you:

- don’t have an up-to-date vaccination
- live in crowded and/or unclean conditions
- travel to a place where diphtheria infections are more common.

As of 2018, the World Health Organization (WHO) has reported increases in diphtheria cases in:

- Indonesia
- India
- South America
- Africa. 



## When to see a doctor 

You should get urgent medical attention if you have [symptoms of diphtheria](https://www.livehealthily.com/health-library/conditions/diphtheria#symptoms-of-diphtheria) and:

- you know you’ve been in contact with someone who has it
- you’re travelling in an area where diphtheria is more common or recently visited somewhere where infection is widespread.

Speak to your doctor if you’re planning to travel to a country or area where there’s a higher risk of diphtheria. You might need a ‘booster’ vaccination if your previous dose was more than 10 years ago.


## What’s the diagnosis and treatment?

A doctor will check if you have diphtheria by:

- asking about your symptoms and examining you
- doing a swab of your throat, nose, or a skin wound,and testing the sample for diphtheria bacteria.

If you have diphtheria, you will need treatment straight away. This will usually be in a hospital, and can last for 2 or 3 weeks.

__Treatment includes:__
- antibiotics – to kill the diphtheria bacteria
- antitoxins – to stop the diphtheria toxin damaging your body
- isolation – to stop you spreading the infection to other people.

If diphtheria is affecting your skin your wounds will be thoroughly cleaned.  

If not treated quickly, diphtheria can lead to serious health problems, including:

- breathing difficulties 
- heart damage, such as [myocarditis](https://www.livehealthily.com/health-library/conditions/myocarditis)
- nerve (neurological) problems that can lead to muscle weakness.

In most cases, treatment for diphtheria is effective. Even if there are further problems, most people recover, although this can take time. 

Having diphtheria once doesn’t mean you can’t get it again, so you should still get vaccinated.

### Treating close contacts

Anyone who has been in close contact with someone with diphtheria may also be treated with antibiotics or given a dose of the vaccine, including household members and individuals in direct contact with the infected patient.


##  Vaccination  

Vaccination is the best way to prevent diphtheria. The vaccine is included in recommended childhood immunizations in countries such as the US and the UK.

It’s usually given in several doses during your childhood, sometimes in a vaccine that also protects against other diseases – such as [tetanus](https://www.livehealthily.com/health-library/conditions/tetanus), [whooping cough](https://www.livehealthily.com/health-library/conditions/whooping-cough), or [polio](https://www.livehealthily.com/health-library/conditions/polio).

Immunity to the diphtheria vaccine fades over time. You may need booster shots of the vaccines to help keep you immune to diphtheria, especially if you’re travelling somewhere where diphtheria is more common. 

Check the [WHO guidelines on vaccines and travel](https://www.who.int/travel-advice/vaccines) for the latest advice.


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References

Fiona Bugler

Susie Parker

Dr Maria Reza

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