What we know about diphtheria as cases of the Victorian-era disease spike

Cases of highly infectious disease on the rise, UKHSA warns

A three-dimensional, computer-generated illustration of a group of Corynebacterium diphtheriae bacteria, based upon scanning electron microscopic imagery (Jennifer Oosthuizen/CDC)

Cases of the highly contagious diphtheria are on the rise in Britain, with three people dying with the disease in the last year, according to the UK Health Security Agency (UKHSA).

The rising number of cases is linked to its increased spread among asylum seekers and people catching it from their pets, the UKHSA said in its latest report, with one of those who died with the disease being held at the controversial Manston processing facility in Kent.

The number of cases of toxigenic diphtheria hit 87 last year, up by 10 on 2021 levels, the public health body cautioned, while also stressing that the chances of the general public catching it remained slim thanks to its being routinely vaccinated against in Britain since the 1940s.

“Our latest report shows that the number of diphtheria cases in the general population in the UK remains very low, with the vast majority of the cases confirmed in this report linked to a previously confirmed outbreak in migrants,” said Gayatri Amirthalingam, the UKHSA’s deputy director for public health programmes.

“Thanks to the success of the diphtheria vaccination programme in the UK, the risk to the wider public from diphtheria is very low. However, in recent years, we have seen vaccine uptake fall among young people due to the challenges posed by the pandemic and this leaves children and young people who are not fully vaccinated at risk.

“I would urge parents of children and young people who have missed out on these important vaccines to contact their school nurse, school immunisation team or GP surgery to arrange a catch-up as these vaccines offer the best protection as young people start their journey into adulthood.”

According to the NHS, diphtheria affects the nose and throat and sometimes the skin and can be fatal in some instances, particularly in children, hence the early administering of vaccines.

British citizens are most likely to encounter the disease when travelling abroad, with the World Health Organisation reporting spikes in Africa, South America, India and Indonesia since 2018.

It is a bacterial infection typically spread through the coughs and sneezes of those who have contracted it, or by touching the cups, cutlery, clothing or bedding of infected people.

The health service states that the symptoms usually begin to manifest between two to five days after infection and might include:

• A thick grey-white coating covering the back of your throat, nose and tongue
• Fever
• Sore throat
• Swollen neck glands
• Difficulty swallowing or breathing

If cutaneous diphtheria is contacted, infecting the skin – most common in countries with poor hygiene – a patient might suffer:

• Pus-filled blisters on their legs, feet or hands
• Large ulcers surrounded by red, sore-looking skin

The NHS urges you to seek urgent medical attention if you have reason to suspect you have contracted diphtheria, particularly if you are in a country where it is known to be prevalent, because it requires hospital treatment to ensure serious breathing or heart afflictions do not develop.

It lists the main treatments as antibiotics, which are used to kill off the bacteria itself, medicines to tackle the toxins it produces and the thorough cleaning of infected wounds.

Treatment typically takes between two to three weeks but patients are warned that skin ulcers can take two to three months to heal and may leave scars behind in their wake.

Anyone who has been in close contact with a sufferer might also require a course of antibiotics or given a belated vaccine dose.