• high temperature (fever) of 38°C (100.4°F) or above
• sore throat
• breathing difficulties

Children are particularly vulnerable to the effects of diphtheria. The most serious cases of diphtheria can be fatal.

An estimated 5-10% of people who get diphtheria will die from complications that arise from the condition, such as breathing difficulties or inflammation of the heart (myocarditis).

How common is diphtheria?

Before a vaccination programme was introduced in 1940, diphtheria was a very common condition and one of the leading causes of death in children. There were 61,000 cases of diphtheria in the UK in 1940 and over 3,000 deaths.

The vaccination programme was very successful. In 2006, there were only 10 recorded cases of diphtheria in England and Wales and one death. It is thought the infections were contracted abroad.

Even though the incidence of diphtheria in England is low, there is a risk that an outbreak could occur if the number of people who are vaccinated falls below a certain level.

This risk was demonstrated by the epidemic that struck the countries of the former Soviet Union between 1990 and 1998, which resulted in 157,000 cases and 5,000 deaths.

The epidemic was thought to be caused by an increase in the number of children who were not vaccinated against diphtheria.

In many places the number of children immunised fell below 60%.

The infection spread to adults whose immunity to the condition had weakened since they first received the vaccination as children.

Vaccination

All children should be vaccinated against diphtheria as part of their routine childhood vaccination schedule.

Adults should consider receiving a booster vaccine when travelling to parts of the world where diphtheria is widespread.

See the information on other pages within this section for more information and advice about diphtheria vaccination.