Understanding Diphtheria: Symptoms, Risks, and Prevention

By SWA

Diphtheria is a serious bacterial infection caused by Corynebacterium diphtheriae. Though rare in countries with established vaccination programs, it remains a global health concern, particularly in areas with low vaccination coverage. The disease can manifest in different parts of the body, leading to a range of symptoms and potentially life-threatening complications. Understanding diphtheria, its symptoms, and how it affects people of all ages—especially adults—can help promote early intervention and prevention.

Symptoms of Diphtheria

Diphtheria symptoms can vary based on the part of the body affected. The infection typically manifests in two main forms:

1. Respiratory Diphtheria

This is the most common and dangerous form of diphtheria, primarily affecting the throat and respiratory system. Key symptoms include:

  • Thick, gray or white coating in the throat or tonsils (known as a "pseudomembrane"), which can obstruct airways.
  • Sore throat that worsens over time.
  • Difficulty breathing or swallowing due to throat swelling.
  • Hoarseness or changes in voice caused by inflammation.
  • Swollen lymph nodes in the neck (commonly called "bull neck").
  • Fever and chills as the body reacts to the infection.
  • Runny nose, sometimes with blood-stained discharge.

These symptoms are caused by toxins produced by the bacteria, which can damage tissues and lead to further complications if untreated.

2. Cutaneous (Skin) Diphtheria

This less common form of diphtheria affects the skin. Symptoms include:

  • Painful, red sores or ulcers that may be covered by a grayish membrane.
  • Swelling or inflammation around the affected areas.
  • Slow-healing skin infections, often occurring in individuals with poor hygiene or in overcrowded living conditions.

Severe or Advanced Symptoms

If left untreated, diphtheria can progress and cause life-threatening complications as the toxins spread through the bloodstream. These severe symptoms include:

  • Heart damage (myocarditis): Irregular heartbeat, chest pain, or even heart failure.
  • Nerve damage: Paralysis or muscle weakness, particularly in the arms, legs, or throat.
  • Kidney failure: As the infection spreads, it may impair kidney function.

Diphtheria is a medical emergency, and timely treatment is essential to prevent these complications.

Can Adults Get Diphtheria?

Yes, adults can get diphtheria, though it is rare in regions with widespread vaccination programs. However, certain groups are at higher risk:

Who is at Risk?

  • Unvaccinated Adults: Those who were never vaccinated during childhood are at greater risk of contracting diphtheria.
  • Adults with Incomplete Vaccination: People who have missed vaccine doses or failed to receive the recommended booster shots.
  • High-Risk Areas: Adults living in or traveling to regions where diphtheria outbreaks occur, often due to low vaccination rates.
  • Weakened Immune Systems: Adults with underlying health conditions or compromised immunity are more susceptible.
  • Frequent Exposure: Healthcare workers or caregivers in close contact with infected individuals may also be at risk.

How Can Adults Contract Diphtheria?

Diphtheria is highly contagious and spreads in several ways:

  • Respiratory droplets: Through coughing, sneezing, or talking with an infected person.
  • Direct contact: Touching infected wounds or sores caused by cutaneous diphtheria.
  • Contaminated objects: Sharing utensils, tissues, or other items handled by an infected person.

Symptoms of Diphtheria in Adults

The symptoms of diphtheria in adults are largely the same as those in children:

  • Sore throat and difficulty swallowing.
  • Thick, grayish-white coating in the throat or nose.
  • Fever, weakness, and swollen lymph nodes in the neck.
  • Painful skin sores in cases of cutaneous diphtheria.

Prevention of Diphtheria in Adults

Vaccination remains the most effective way to prevent diphtheria. The disease can be prevented with a series of vaccines and regular booster doses throughout life.

Recommended Vaccination Guidelines for Adults:

  • Tdap Booster Every 10 Years: Adults should receive a tetanus, diphtheria, and pertussis (Tdap) booster every decade to maintain immunity.
  • Catch-Up Vaccination: Unvaccinated adults or those with incomplete vaccination histories should complete a full series of Tdap vaccines.
  • Before Travel: Adults traveling to regions where diphtheria is more common should ensure they are up to date with their vaccinations.

Other Preventive Measures:

  • Good Hygiene Practices: Regular handwashing and avoiding close contact with sick individuals can reduce the risk of infection.
  • Awareness: Knowing the symptoms and seeking early medical attention can prevent the spread of the disease and serious complications.

Treatment of Diphtheria in Adults

If an adult contracts diphtheria, immediate treatment is essential. Standard treatment includes:

  1. Antitoxin: Administered to neutralize the toxins produced by the bacteria.
  2. Antibiotics: Medications like penicillin or erythromycin are prescribed to kill the bacteria and stop its spread.
  3. Isolation: To prevent the infection from spreading to others, patients are often isolated during treatment.

Conclusion

Diphtheria is a potentially life-threatening bacterial infection, but it is preventable through vaccination. While cases are rare in vaccinated populations, adults who are unvaccinated or overdue for booster shots remain at risk, particularly in high-risk regions. Understanding the symptoms—such as the thick throat membrane and difficulty breathing—and seeking immediate medical care can save lives. By staying vigilant and up to date with vaccinations, we can protect ourselves and others from this serious disease.

© 2000-2025 Sieglinde W. Alexander. All writings by Sieglinde W. Alexander have a fife year copy right.
Library of Congress Card Number: LCN 00-192742
ISBN: 0-9703195-0-9

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