Diphtheria

Diphtheria is a serious bacterial infection caused by Corynebacterium diphtheriae. It most often affects the throat and nose, where it produces a thick greyish coating that can block breathing. A toxin made by the bacteria can damage the heart, nerves, and kidneys. Diphtheria was once widespread but is now rare in most countries — including in India — thanks to routine childhood vaccination. Occasional cases and outbreaks still occur, especially where vaccination coverage is incomplete.

How it spreads

• Through the air — respiratory droplets from coughs and sneezes
• Direct contact with infected sores (cutaneous diphtheria)
• Contaminated surfaces or shared items

Symptoms

Symptoms usually start 2-5 days after exposure:

• Sore throat
• Low-grade fever
• Thick grey-white coating (membrane) at the back of the throat and tonsils — the hallmark sign
• Swollen glands in the neck ("bull neck" in severe cases)
• Difficulty breathing or swallowing
• Hoarse voice
• Weakness
• Cutaneous diphtheria — skin ulcers with a grey membrane, mostly in warm, tropical regions

Complications

The toxin can cause:

• Airway obstruction — the membrane can block breathing
• Myocarditis (heart muscle inflammation) — can cause heart failure or arrhythmia
• Nerve damage — weakness, paralysis, difficulty swallowing
• Kidney damage
• Death — even with treatment, diphtheria kills around 1 in 10 people it infects

Treatment

Diphtheria is a medical emergency:

• Diphtheria antitoxin — to neutralise the toxin; given as early as possible
• Antibiotics — to kill the bacteria
• Hospital admission, often in isolation
• Supportive care — airway management (sometimes a breathing tube), fluids, monitoring for heart and nerve complications
• Close contacts need evaluation, antibiotic prophylaxis, and vaccination updates

Prevention

Diphtheria is preventable with vaccination:

• The DPT (or pentavalent) vaccine is part of India's Universal Immunisation Programme for infants
• Booster doses in childhood and adolescence (Td)
• Adults should have a tetanus-diphtheria (Td) booster every 10 years
• Make sure your and your children's vaccinations are up to date — ask your doctor or local health centre if unsure