What is diphtheria?

[igDiphtheria is caused by bacteria that produce a strong toxin. The toxin can destroy tissues in the body, such as parts of the skin or lungs. Tissues in the heart, nervous system and kidneys can also be damaged by the toxin. A diphtheria patient will have different symptoms depending on where the bacteria enter the body.

What are the symptoms of diphtheria?

Diphtheria can cause many different kinds of symptoms. This is because the infection can occur in various parts of the body. An infection in the nose often only causes mild symptoms, for example. If diphtheria causes a skin infection, it leads to skin sores. This is the form that is most common in the Netherlands, and could also still occur in people who are vaccinated. However, the vaccination does prevent serious illness.

Diphtheria in the respiratory system can cause more serious symptoms:

• sore throat
• elevated temperature or fever
• drowsiness
• shortness of breath
• difficulty swallowing
• crossed eyes or vision problems
• weaker muscles in arms or legs.

In 10 to 20% of people who have serious diphtheria, the bacteria affect the heart. The nervous system can also be damaged by diphtheria. Diphtheria can be fatal, but almost never in people who are fully vaccinated.

Who can become very ill from diphtheria?

Some people have a higher risk of severe disease:

• Children under 5 years old
• People who are unvaccinated or not fully vaccinated

Various things can affect how ill a person can become. Diphtheria may be more serious depending on where the bacteria is found in the body, the toxin levels produced by the bacteria, and if you are fully vaccinated.

How does diphtheria spread?

Diphtheria is an infectious disease that is transmitted from person to person. It is caused by bacteria that spread through coughing and sneezing. You can also get diphtheria by touching a contaminated wound or by kissing a person who has the disease. The incubation period between exposure and illness is 7 days at most. It is usually between 2 and 5 days.

How can I prevent diphtheria?

You can protect yourself against diphtheria with a vaccination. In the Netherlands, babies and children are vaccinated against diphtheria through the National Immunisation Programme.

Is there any treatment for diphtheria?

Diphtheria can be treated with antibiotics. If a person has diphtheria in their lungs, they may sometimes be treated with antitoxin. If that happens, the patient has to go to hospital. Diphtheria in the throat, airways or lungs must be treated right away. Without immediate treatment, the patient could develop severe symptoms.

With treatment, most people recover from diphtheria. However, not everyone can recover fully from damage already caused by the disease.

How common is diphtheria in the Netherlands?

Diphtheria is rare in the Netherlands these days. In 2024, there were only 3 reported cases of diphtheria in the Netherlands. Most people who have diphtheria contract the disease while travelling in a country where diphtheria is common. Before a vaccination against diphtheria was available, between 100 and 10,000 people in the Netherlands died from diphtheria every year. Since 1994, there have been no deaths from diphtheria in the Netherlands.

Can a person with diphtheria go to childcare, school or work?

Diphtheria is very contagious. That is why people with diphtheria generally are not allowed to go to childcare, school or work. There are a few specific forms of diphtheria that would make it possible in some situations. The company doctor or Municipal Public Health Service (GGD) will determine which situation applies to you or your child.