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Diphtheria

Introduction

Diphtheria is a highly contagious infection spread mainly through respiratory secretions from coughs and sneezes. It can cause severe difficulties with breathing.

Recommendations for travellers

Diphtheria is a disease which is vaccine preventable. Make sure you have completed the national schedule of vaccines for life in the UK.

  • This means receiving five doses of a vaccine giving protection against diphtheria by the time you are a teenager.

To reduce your risk of becoming infected whilst travelling, you should practice good respiratory hygiene and hand hygiene, especially when you are in or have recently been in overcrowded or busy places.

Vaccination

Even after completing the childhood vaccination schedule, you may still require a booster dose of the vaccine every 10 years if you are travelling to an area where diphtheria is considered to be high risk.

Overview of the Disease

Diphtheria is caused by a type of bacteria called Corynebacterium that make a toxin (poison). It is the toxin that can cause people to become sick.

The bacteria spread from person to person through respiratory droplets when an infected person sneezes or coughs. The disease can also be spread if you touch a surface contaminated with infected respiratory secretions, or from direct contact with infected skin lesions (sores or ulcers), clothing or bed linen.

Diphtheria is rare in the UK because babies and children are routinely vaccinated against it. The disease remains a big problem in parts of Africa, South America, Eastern Europe, Russia, Central and South East Asia where vaccine coverage is low.

The Illness

Diphtheria can affect the respiratory (breathing) system or the skin. The ‘toxin’ kills healthy tissues which can result in the formation of a thick greyish-white coating which can build up in the nose or the back of the throat.

Symptoms usually start 2-5 days after becoming infected.

The main symptoms of diphtheria are:

  • a thick a thick greyish-white coating at the back of your throat
  • a high temperature (fever)
  • sore throat or swollen glands in your neck
  • feeling sick (nausea)
  • difficulty in breathing or swallowing

In severe cases, the airways become blocked making it very hard to breathe or swallow.

The bacteria that cause diphtheria can also infect the skin causing open sores or ulcers. This form of diphtheria is usually mild and is commonly found on lower legs, feet and hands.

If diphtheria toxins enter the bloodstream, it can cause damage to the nerves, heart and other major organs, even if recovery appears to have been made weeks earlier.

Treatment

Antibiotics are used to treat both respiratory and skin types of diphtheria. Treatment usually lasts for 2-3 weeks. Skin ulcers usually heal within 2-3 months but might leave a scar.

Sometimes, medicines called antitoxins are used to stop the toxin from damaging the body.

Those with breathing difficulties need to be treated in hospital to assist their breathing and help prevent complications.

Those who have been in close contact with someone who has diphtheria may be required to take antibiotics or be vaccinated. Check with your GP if you are unsure.

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