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Diphtheria

What is diphtheria?

Diphtheria is an acute bacterial disease. There are 2 types. Respiratory diphtheria infects your tonsils, nose, or throat. Cutaneous diphtheria affects your skin. Diphtheria was a common childhood disease in the 1930s. But a vaccine against it has now made it very rare in the U.S. and other developed countries.

How is diphtheria transmitted?

Diphtheria is transmitted from person to person. The bacterium can get into your body through your nose and mouth or through a break in your skin. You can get it if an infected person coughs or sneezes and you touch or breathe in the droplets. You can also get the disease if you touch a contaminated object. After you are exposed to the bacterium, it often takes 2 to 4 days for symptoms to develop.

What are the symptoms of diphtheria?

Each person may have different symptoms. But these are the most common symptoms of diphtheria:

  • Respiratory diphtheria. When a person is infected with diphtheria, the bacterium often multiplies in the throat. This leads to the respiratory type of diphtheria. A membrane may form over the throat and tonsils, causing a sore throat. Other common symptoms of this type may include:

    • Trouble breathing because of the membrane

    • Husky voice

    • Enlarged lymph glands

    • Increased heart rate

    • Stridor (a harsh or high-pitched sound made during breathing due to narrowing of the upper airways in the body)

    • Nasal drainage

    • Swelling of the palate (roof of the mouth)

    • Sore throat

    • Low-grade fever

    • Malaise

    People may die from asphyxiation when the membrane obstructs breathing. Other complications of this type are caused by the diphtheria toxin released in the blood. This leads to heart or kidney failure and nerve problems.

  • Skin (cutaneous) diphtheria. With this type of diphtheria, the symptoms are usually milder. They may include yellow spots or sores on the skin.

These symptoms may look like other health problems. Always talk with your healthcare provider for a diagnosis.

What is the treatment for diphtheria?

Your healthcare provider will take into account your symptoms, overall health, your age, and other factors when advising treatment for you.

You may need:

  • Antibiotics. These often help treat respiratory diphtheria before it releases toxins in the blood.

  • Antitoxin. You may be given an antitoxin to take with the antibiotics.

  • Tracheostomy. You may need this procedure if you have severe breathing problems. During this procedure, a healthcare provider puts a breathing tube in your windpipe.

How is diphtheria prevented?

A vaccine can help prevent diphtheria. In their first year of life, children in the U.S. are routinely given a vaccine for diphtheria with several booster doses in childhood. This has made cases of diphtheria very rare in the U.S. But the disease still prevails in underdeveloped countries. So the vaccine is still needed in case of exposure to a carrier (a person with diphtheria) who is visiting from another country or if a person travels to an area where diphtheria exists.

The CDC recommends that children get 5 DTaP shots. A DTaP shot is a combination vaccine that protects against 3 diseases—diphtheria, tetanus, and pertussis. The first 3 shots are given at 2, 4, and 6 months of age. Between 15 and 18 months of age, a child gets the fourth shot. A child then gets the fifth shot when entering school at 4 to 6 years of age.

At regular checkups for 11- or 12-year-olds, a preteen should get a dose of Tdap. The Tdap booster protects against tetanus, diphtheria, and pertussis. If an adult did not get a Tdap as a preteen or teen, then that person should get a dose of Tdap instead of the older type of booster shot (Td booster). Adults should then get a Td booster every 10 years. But it can be given before the 10-year mark. Always talk with your healthcare provider for advice.

Online Medical Reviewer: Barry Zingman MD
Online Medical Reviewer: Lu Cunningham
Date Last Reviewed: 2/1/2019
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