Diphtheria: symptoms, how it spreads, treatment and vaccination

The NHS describes diphtheria as a contagious bacterial infection that affects the nose and throat, and sometimes the skin. UKHSA’s Green Book chapter says it is an acute infectious disease of the upper respiratory tract, and occasionally the skin, caused by diphtheria toxin produced by toxigenic Corynebacterium diphtheriae or Corynebacterium ulcerans.

The NHS says it can be a serious illness and sometimes fatal, especially in children, if not treated quickly, and that vaccination can prevent it.

According to the NHS, diphtheria of the throat and nose causes the symptoms below, which usually start 2 to 5 days after becoming infected.

• A thick grey-white coating that may cover the back of the throat, nose and tongue.

• A high temperature (fever).

• A sore throat.

• Swollen glands in the neck.

• Difficulty breathing and swallowing.

The NHS says that in places with poor hygiene, infection of the skin is more common. Cutaneous diphtheria can cause pus-filled blisters on the legs, feet and hands, and large ulcers surrounded by red, sore-looking skin. Skin ulcers usually heal within 2 to 3 months but may leave a scar.

Yes. The NHS says diphtheria is a contagious bacterial infection spread by coughs and sneezes, or through close contact with someone who is infected. You can also get it by sharing items such as cups, cutlery, clothing or bedding with an infected person.

It can spread to others easily, so if you think you may have it, call your GP surgery before you go in; they may suggest talking over the phone.

The NHS lists the main treatments as antibiotics to kill the diphtheria bacteria, medicines that stop the effects of the harmful substances (toxins) produced by the bacteria, and thoroughly cleaning any infected wounds if the skin is affected. Treatment usually lasts 2 weeks.

People who have been in close contact with someone who has diphtheria will also need antibiotics and may be given the diphtheria vaccine. The NHS says a contact tracing team will get in touch with anyone who needs to be treated.

The NHS says diphtheria is rare in the UK because babies and children have been routinely vaccinated since the 1940s. Protection comes from a combined vaccine at several ages.

The NHS says the best way to avoid diphtheria while travelling is to be fully vaccinated. If you travel to a part of the world where there may be a risk, you may need a booster if you were last vaccinated more than 10 years ago. It lists Africa, South America, India, south east Asia and eastern Europe as parts of the world where there may be a risk, and says that places with higher cases change over time, so check the TravelHealthPro country guides.

You may be able to get a combined diphtheria, tetanus and polio vaccine free on the NHS; ask at your GP surgery.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you have travelled to a country where diphtheria is found and have diphtheria symptoms, or you have been in close contact with someone who has diphtheria. Call your GP surgery before going in.

If you have symptoms while travelling, get medical help as soon as possible rather than waiting until you get back to the UK. Call 999 if someone has severe difficulty breathing.

Childhood diphtheria vaccination is part of the NHS schedule and is free. Adult boosters for travel are arranged through a GP practice or private travel clinic; the NHS says a combined vaccine may be free, so ask your practice. Suspected diphtheria is managed by NHS services, with public health teams handling contact tracing.