Diphtheria is a serious infection of the respiratory tract.
It remains a problem in the developing world (sub-Saharan Africa, parts of South East Asia and South America).
The disease is transmitted by sneezing, coughing or by direct contact with respiratory secretions or by direct contact with skin lesions of an infected person.
Diphtheria can cause serious inflammation of the respiratory tract and a greyish-white membrane is seen at the back of the throat. In the most severe cases the airway can become blocked and death can result.
The bacteria that cause diphtheria can also invade skin injuries and wounds. This form of diphtheria is usually mild and is commonly found on lower legs, feet and hands.
Where bacterial toxins are released, diphtheria can cause heart damage and multi-organ failure even if recovery appears to have been made weeks earlier.
Treatment for diphtheria, both respiratory and skin, is with specific antibiotics and antitoxin. Assisted breathing may be required for those who suffer from airway obstruction.
Recommendations for travellers
Respiratory infections are often difficult to prevent but following basic personal hygiene etiquette when coughing and sneezing can help. Avoiding overcrowded areas such as busy markets and local transport may also reduce risk of exposure but may not always be practical.
A combination vaccine called Revaxis is available to protect adults against diphtheria, tetanus and polio. Children normally receive these vaccinations as part of the national schedule. Travellers should ensure that they have had a primary course of vaccine and receive a booster every 10 years if they are travelling to an area where diphtheria, tetanus or polio are considered high risk.
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