Diphtheria is caused by a potent toxin produced by certain strains of the bacterium, Corynebacterium diphtheriae. This very serious disease can be prevented through vaccination.


In the Asian country of Laos, diphtheria outbreaks have been reported in a third of the country’s provinces accounting for 588 cases through October 2015.

The cases occurred mainly in children under the age of 15, accounting for 61 per cent, or who had not been vaccinated against the contagious disease. Unfortunately, 11 diphtheria deaths have occurred.

The diphtheria situation in Laos has sparked concern for their neighbors to the east. The Vietnamese Ministry of Health warns that the Laos outbreak can spread to the border region between Viet Nam and Laos then to other areas of the country.

Health officials are keeping a close eye on what’s happening and are recommending the DTP (Diphtheria – Pertussis – Tetanus) for the public, particularly children.

Diphtheria is extremely contagious through coughing or sneezing. Risk factors include crowding, poor hygiene, and lack of immunization.

Symptoms usually appear within a week of infection. This infection is characterized by a sore throat, coughing and fever very similar to many common diseases like strep throat. Additional symptoms may be bloody, waterydischarge from the nose and rapid breathing. However, a presumptive diagnosis can be made by observing a characteristic thick grayish patch (membrane) found in the throat. In more severe cases, neck swelling and airway obstruction may be observed.

This child with diphtheria presented with a characteristic swollen neck, sometimes referred to as “bull neck”.  Image/CDC
This child with diphtheria presented with a characteristic swollen neck, sometimes referred to as “bull neck”. Image/CDC

In the tropics, cutaneous and wound diphtheria is much more common and can be a source of transmission.

The real serious danger is when the toxin that is produced by the bacterium gets into the bloodstream and spreads to organs like the heart and nervous system. Myocarditis, congestive heart failure and neurological illnesses of paralysis that mimic Guillain-Barre syndrome are most severe. Even withtreatment, fatalities are still seen in up to 10% of cases.

Diphtheria can be treated and cured successfully with antitoxin and antibiotics if started early enough.

The prevention of diphtheria is through vaccination. Immunity does wane after a period of time and revaccination should be done at least every 10 years.

Robert Herriman is a microbiologist and the Editor-in-Chief of Outbreak News Today

Follow @bactiman63