17870 Diphtheria

Overview

Diphtheria is a serious bacterial infection that usually affects the throat and sometimes the skin. The bacteria produce a toxin (poison) that can lead to a thick coating in the throat, making it hard to breathe. Thanks to vaccination, diphtheria is now rare in many parts of the world, but it can still be very dangerous if it occurs.

No, diphtheria is very rare in countries with strong vaccination programs. However, it still occurs in some parts of the world, and anyone who is not vaccinated can get it.

Diphtheria can affect people of all ages, but unvaccinated children and adults are at highest risk. People who travel to or live in areas where diphtheria is common are also at greater risk.

Symptoms

Common symptoms

• Sore throat
• Fever
• Swollen glands in the neck
• A thick gray or white coating on the tonsils and throat
• Difficulty breathing or rapid breathing
• Weakness
• Runny nose (sometimes with a bad smell)

Causes

Main causes

• Infection with Corynebacterium diphtheriae bacteria
• The bacteria produce a toxin that damages tissue and can affect the heart and nerves
• Spread through droplets from coughing or sneezing, or by touching infected skin sores

Risk factors

• Not being vaccinated against diphtheria
• Traveling to countries where diphtheria is still common
• Living in crowded or unsanitary conditions
• Having a weakened immune system

When to see a doctor

See a doctor urgently if:

• If you or your child has a thick gray coating on the throat or tonsils
• If you have difficulty breathing or swallowing
• If you have been in close contact with someone who has diphtheria

Book a routine appointment if:

• If you are not sure whether you or your child has been vaccinated against diphtheria
• Before traveling to a country where diphtheria is common, ask your healthcare provider about vaccination

Diagnosis

A doctor will ask about your symptoms and medical history and will look at your throat. To confirm diphtheria, they will take a swab from your throat or nose and send it to a laboratory for testing.

Tests that may be done

• Throat or nose swab to check for the bacteria
• Swab from any skin sores
• Blood tests to look for signs of infection or damage to organs

What to expect at your appointment

If a doctor suspects diphtheria, they may start treatment right away, even before test results come back. You will likely need to stay in the hospital so that your breathing can be monitored and to prevent the infection from spreading to others.

Treatment

Diphtheria is treated in a hospital. Treatment involves giving a medicine called diphtheria antitoxin to stop the toxin from damaging your body, and antibiotics to kill the bacteria. You will need to stay in isolation until tests show you are no longer contagious.

Self-care at home

• Rest as much as possible to help your body recover.
• Drink plenty of fluids to avoid dehydration, especially if swallowing is painful.
• Use a cool-mist humidifier or steam to help ease breathing, if your doctor says it is safe.
• Stay isolated from others until your doctor says it is safe to be around people.

Medical treatments

Treatment in the hospital usually includes an antitoxin that blocks the bacteria's poison and antibiotics that kill the bacteria. You may also receive fluids through an IV and oxygen if you have trouble breathing. In rare, severe cases, a breathing tube may be needed to help keep your airway open.

When is surgery considered?

Surgery is not usually needed for diphtheria. In very severe cases, a doctor may need to insert a breathing tube or create an opening in the windpipe (a tracheostomy) to help you breathe, but this is only done in a hospital.

Living with this condition

Diphtheria usually requires a hospital stay until the infection is under control. After leaving the hospital, you will need to rest and may feel weak for a while. Your doctor will tell you when it is safe to return to work or school.

Lifestyle tips

• Finish all medicines exactly as your doctor prescribes.
• Keep all follow-up appointments so your doctor can check your recovery.
• Wash your hands often and cover coughs and sneezes to avoid spreading infection.

Diet and exercise

While your throat is sore, choose soft, easy-to-swallow foods like soup, yogurt, and mashed potatoes. Drink plenty of water. When you feel stronger, gradually increase your activity, but take plenty of rest.

Mental health and emotional wellbeing

Being sick with a serious infection can be scary and stressful. You may feel anxious or low while recovering. Talk to your care team or a trusted friend about how you are feeling. It is normal to need support.

Prevention

Yes, diphtheria can be prevented with vaccination. The vaccine is often given as a combination shot with other vaccines and is part of routine childhood immunisations in many countries. Booster doses are recommended for adults to keep up protection.

Vaccines

The diphtheria vaccine is usually given as part of a combination vaccine. In the UK, it is given multiple times in childhood and as a booster later in life. Ask your doctor or local health service for advice about your vaccination status.

Screening programmes

There is no routine screening for diphtheria. The best prevention is vaccination and avoiding close contact with someone who is infected.

Complications

If left untreated

• Breathing blockage caused by the thick coating in the throat
• Damage to the heart muscle, which can lead to heart failure
• Nerve damage, which can cause weakness or paralysis
• Kidney damage

Long-term outlook

With early hospital treatment, most people recover fully from diphtheria. The sooner treatment begins, the lower the risk of serious complications. Even after recovery, you may need follow-up care to make sure your heart and nerves are healthy.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.