WHO / Aphaluck Bhatiasevi
First round of a vaccination campaign at Kutupalong Camp, which hosts around 800,000 Rohingya displaced people. Children from 6 weeks to 15 years were vaccinated for diphtheria, tetanus, and polio in this camp of Cox's Bazar, Bangladesh.
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Diphtheria

    Overview

    Diphtheria is a serious infection caused by strains of the bacteria called Corynebacterium diphtheriae which makes a toxin. The toxin attaches itself most commonly to tissues in the respiratory system and causes disease by killing healthy tissue.  

    Typical symptoms of the infection include a sore throat, fever, swollen neck glands and weakness. Within 2–3 days from infection, the dead tissue forms a thick, grey coating that can cover tissues in the nose, tonsils and throat, making it hard to breathe and swallow. More rarely, the toxin gets into the blood stream and causes damage to the heart, kidneys and nerves. 

    Diphtheria bacteria spread from person to person, usually through respiratory droplets, like from coughing or sneezing. People can also get sick from touching infected open sores or ulcers. Those at increased risk of getting sick include household contacts, those exposed to secretions from the patient and those with frequent and close contact with the infected person.  

    Prevention

    Diphtheria is a vaccine-preventable disease and is included in all countries' essential immunization programme. Diphtheria vaccine is a bacterial toxoid, i.e. a toxin whose toxicity has been inactivated. Currently available diphtheria vaccines are very effective in preventing this disease.  

    WHO recommends a 3-dose primary vaccination series with diphtheria- containing vaccine, followed by 3 booster doses. The primary series should begin as early as 6 weeks of age with subsequent doses given with a minimum interval of 4 weeks between doses. The 3 booster doses should preferably be given during the second year of life (12–23 months), at 4–7 years and at 9–15 years of age. Ideally, there should be at least 4 years between booster doses to achieve long term protection. 

    The vaccine can be given in combination with other vaccines such as tetanus, pertussis, hepatitis B, Hemophilus influenzae b and polio. 

    People who get a diphtheria vaccine may experience mild side effects. Serious side effects are rare.  

    Treatments

    Treatment for diphtheria includes antibiotics to get rid of the bacteria. For serious illnesses, diphtheria antitoxin is used to stop the bacterial toxin from causing damage to the respiratory system and other parts of the body. Anyone who has had diphtheria should also receive the vaccine after the acute phase of the illness is over. 

    Close contacts of a person with diphtheria may also be treated with antibiotics.  This prevents further spread of the bacteria. The specific antibiotics used will depend on local known antibiotic resistance patterns. 

    The risk of complications or death decrease considerably if appropriate treatment is provided early in the course of illness. For this reason, if diphtheria is suspected, testing to confirm the disease should be done promptly, and treatment should be started as soon as possible.  

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    Infection prevention and control measures when caring for patients with suspected or confirmed respiratory diphtheria: a summary

    This operational guide addresses important infection prevention and control (IPC) measures that should be implemented during a diphtheria outbreak and...

    Infection prevention and control and water, sanitation and hygiene measures for diphtheria in health-care settings: operational guide

    This operational guide addresses important infection prevention and control (IPC) measures that should be implemented during a diphtheria outbreak and...

    Clinical management of diphtheria: guideline, 2 February 2024 

    The WHO Clinical management of diphtheria contains the most up-to-date recommendations for the clinical management of people with diphtheria....

    Laboratory testing for diphtheria in outbreak settings: Interim guidance, 26 January 2024

    This document provides detailed guidance on laboratory testing for suspected diphtheria cases during significant outbreaks or in low-resource settings....

    Documents

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    WHO 2nd International Standard - Diphtheria Antitoxin Equine Cover

    This document has been prepared for the purpose of inviting comments and suggestions on the proposals contained therein, which will then be considered...

    WHO_SurveillanceVaccinePreventable_04_Diphtheria_R2_page1

    Diphtheria is caused by Corynebacterium species, mostly by toxin-producing Corynebacterium diphtheriae and rarely by toxin-producing strains of C....

    In accordance with its mandate to provide guidance to Member States on health policy matters, WHO is issuing a series of regularly updated...

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