Diphtheria is an acute bacterial disease that usually affects the tonsils, throat, nose, and/or skin. The disease is passed from person to person by droplet transmission, usually by breathing in bacteria after an infected person has coughed, sneezed, or even laughed. It can also be spread by handling used tissues or by drinking from a glass used by an infected person. People can also get sick from touching infected sores on persons with the skin form of diphtheria. The diphtheria bacteria make a toxin that sickens people. Diphtheria can lead to breathing problems, heart failure, paralysis, and sometimes death.

Burden

• Nearly one out of every 10 people who get respiratory diphtheria will die from it.
• Most cases of diphtheria occur among unvaccinated or inadequately vaccinated people.
• Although no longer a very common disease in the US, diphtheria remains a large problem in other countries and can pose a serious threat to people in the US who may not be fully immunized and who travel to other countries, or have contact with people coming to the US from other parts of the world.

Signs and symptoms may vary from mild to severe. They usually start two to five days after exposure. Symptoms often come on fairly gradually, beginning with a sore throat and fever. In its early stages, diphtheria may be mistaken for a severe sore throat. Other symptoms include a low-grade fever and enlarged lymph nodes (swollen glands) located in the neck. Diphtheria can cause skin lesions that may be painful, red, and swollen. People carrying diphtheria germs are contagious for up to four weeks without antibiotics, even if they themselves do not develop symptoms.

There is a vaccine to prevent diphtheria. Most people receive their first dose as children in the form of a combined vaccine called DTaP (diphtheria-tetanus-acellular pertussis). A booster dose is recommended for adolescents as Tdap (tetanus-diphtheria-pertussis vaccine). Health officials now recommend that all adults receive at least one dose of Tdap. After that dose, Tdap or Td (tetanus-diphtheria vaccine) can be used for needed booster doses.

Treatment for respiratory diphtheria involves using antitoxin to stop the toxin made by the bacteria from damaging the body. Antibiotics may be used to kill and get rid of the bacteria for both infections in the respiratory system and on the skin.

Facts about Diphtheria

• Diphtheria is transmitted to others through close contact with discharges from an infected person’s nose, throat, eyes, and/or skin lesions.
• Diphtheria can lead to breathing problems, heart failure, paralysis, and sometimes death.
• Recovery from diphtheria is not always followed by lasting immunity, so even those persons who have survived the disease need to be immunized.

Reviewed April 2021

Source: Centers for Disease Control and Prevention