Introduction 

Diphtheria is a contagious bacterial infection that mainly affects the nose and throat. Less commonly, it can also affect the skin.

Diphtheria is highly contagious. The bacteria spread when an infected person coughs or sneezes and droplets of their saliva enter another person's mouth or nose.

Diphtheria is very rare in England because most people have been vaccinated against it.

The symptoms of diphtheria include:

  • a high temperature (fever) of 38ºC (100.4ºF) or above
  • sore throat
  • breathing difficulties
  • a grey-white membrane developing in the throat

Diagnosing diphtheria

A diagnosis of diphtheria can be confirmed by taking a swab of the throat, nose or wound on the skin. A swab is similar to a cotton bud and collects a small sample of cells.

The sample will be examined under a microscope to see whether the bacteria that cause diphtheria are present.

Treating diphtheria

Diphtheria must be treated quickly to prevent serious complications developing. If diphtheria is suspected, treatment is therefore likely to begin before any test results are confirmed.

Diphtheria is treated with antibiotic and antitoxin medicine. Anyone suspected of having the condition will be put in isolation when they are admitted to hospital.

Children are particularly vulnerable to the effects of diphtheria. The most serious cases can be fatal.

An estimated 5-10% of people who get the infection will die from complications of diphtheria, such as breathing difficulties, inflammation of the heart (myocarditis) or problems with the nervous system.

Vaccination

All children should be vaccinated against diphtheria as part of the routine childhood vaccination schedule.

Adults should consider having a booster vaccine when travelling to parts of the world where diphtheria is widespread.

Read more information about the diphtheria vaccination.

How common is diphtheria?

Before a vaccination programme was introduced in 1940, diphtheria was a very common condition and one of the leading causes of death in children.

The vaccination programme has been very successful. Since 1986, there have been only 15 recorded cases of diphtheria in England and Wales, and no deaths. Diphtheria is a notifiable disease, which means that if a doctor diagnoses the condition, they must tell the local authority.

Even though the incidence of diphtheria in England is low, there's a risk that an outbreak could occur if the number of people who are vaccinated falls below a certain level.

This risk was demonstrated by the diphtheria epidemic that struck the countries of the former Soviet Union between 1990 and 1998. It resulted in 157,000 cases and 5,000 deaths. The epidemic was caused by an increase in the number of children who were not vaccinated against the disease.

All children should be vaccinated against diphtheria at two months of age as part of the routine childhood vaccination schedule 

How vaccines work

Find out how vaccines work, how they're monitored, and the benefits of vaccination programmes

Page last reviewed: 15/03/2013

Next review due: 15/03/2015