A smiling woman leaning against an indoor wall.

Although rare in Australia diphtheria continues to cause illness in some countries. It’s possible to have the disease without symptoms, so it could be brought into Australia by travellers to or from countries where disease still occurs.

Did you know?

  • Diphtheria was once a common cause of death in Australia. A vaccine has been available since the early 1900s and today the disease has almost disappeared in Australia.
  • The bacterium Corynebacterium diphtheriae makes a toxin that acts like a poison.
A young man standing in front of a university building.

What is it?

Diphtheria is a serious and potentially life-threatening disease of the airways or sometimes of the skin that is caused by the bacterium Corynebacterium diphtheriae. The poisonous toxin produced by the bacteria usually covers the throat in a grey membrane, making it very hard to breathe. If the poison spreads beyond the throat, it can also lead to skin sores, nerve damage and heart problems.

While it is now extremely rare in Australia, immunising against diphtheria is still important. The infection can be brought into the country by people who have travelled to, or have come from, countries where diphtheria is still common.

What are the symptoms?

The symptoms of diphtheria appear gradually, between 2 and 5 days after infection. It usually starts as a mild fever, sore throat, difficulty swallowing, generally feeling unwell and a loss of appetite.

Within 2 to 3 days of these first symptoms appearing, a firm, fleshy, grey and sticky coating develops in the throat, which bleeds if attempts are made to remove it. The neck may swell up and skin sores may appear.

Without treatment, diphtheria can lead to serious problems such as suffocation, heart damage, kidney damage, nerve damage and sometimes death. Anyone can be affected by diphtheria, but the risks are greater for those who are unimmunised.

This is not a full list of symptoms that can occur following diphtheria infection. Please speak to your doctor if you have any concerns about diphtheria infection.

How is it spread?

Diphtheria is spread from person to person via coughing and sneezing. Less commonly, you could get sick by coming into contact with skin sores or items soiled by an infected person.

A person infected with diphtheria can spread the disease for up to 4 weeks. Some people, known as carriers, can be infected with diphtheria without showing any symptoms – these outwardly healthy people are infectious for about 6 weeks.

Who is at risk?

You may be at increased risk of diphtheria if you: 

  • have not been adequately immunised and are exposed to a person infected with diphtheria,
  • have immune system problems, or
  • travel to countries where diphtheria is still common.

Other people may be at risk of diphtheria infection. Please speak to your doctor regarding your individual circumstances.

Who should be vaccinated?

  • The diphtheria vaccine is recommended and provided free for infants, children and adolescents as part of the National Immunisation Program (NIP). It is usually given at 2, 4, 6 and 18 months, with a booster given at 4 years and again between 10 and 15 years of age.

    Diphtheria is given as part of a combination vaccine that also helps to protect against other diseases.

    Immunisation schedule

    •  Immunisation funded via the National Immunisation Program (NIP)
    Diseases Birth 2 months 4 months 6 months 12 months 18 months 4 years 10 to <15 years 15-19 years
    Chickenpox (varicella)+                  
    A second dose of varicella vaccine is recommended any time between 4 years of age and less than 14 years, at least 4 weeks after the first dose. Speak to your doctor to learn more.
    Diphtheria                  
     
    Hepatitis A+                  
    Two doses of Hepatitis A vaccine are recommended and NIP-funded for Aboriginal and Torres Strait Islander children at 12 months and 18 months living in certain areas. A two-dose schedule (which is not funded) is also recommended for some medically at-risk children and adolescents. Speak to your doctor to learn more.
    Hepatitis B+                  
    An additional booster vaccine is recommended at 12 months of age for preterm infants who were born at less than 32 weeks gestation or whose birth weight was under 2000 grams. Speak to your doctor to learn more.
    Haemophilus influenzae
    type b (Hib)
                     
     
    Human Papillomavirus (HPV)                  
     
    Measles                  
     
    Meningococcal ACWY disease+                  
    The meningococcal ACWY vaccine is strongly recommended (but not funded) for children less than 2 years of age, adolescents (15 - 19 years), Aboriginal and Torres Strait Islander people (2 months - 19 years), and those aged at or above 2 months with certain medical conditions. A free dose is given at 12 months of age. For anyone wishing to reduce their risk of meningococcal disease the vaccine is recommended if their doctor deems it appropriate. Speak to your doctor to learn more or see who is most at risk of meningococcal disease here.
    Meningococcal B disease+                  
    The meningococcal B vaccine is strongly recommended (but not funded) for children less than 2 years of age, adolescents (15 - 19 years), Aboriginal and Torres Strait Islander people (2 months - 19 years), and those aged at or above 2 months with certain medical conditions. For anyone wishing to reduce their risk of meningococcal disease the vaccine is recommended if their doctor deems it appropriate. Speak to your doctor to learn more or see who is most at risk of meningococcal disease here.
    Mumps                  
     
    Pneumococcal disease+                  
    An additional dose of pneumococcal vaccine is recommended and NIP-funded at 6 months of age for Aboriginal and Torres Strait Islander children. Two additional doses (at 6 months and 4 years) are recommended and NIP-funded for medically-at risk children. Further doses may be recommended and funded during adolescence depending on risk – speak to your doctor to learn more.
    Polio                  
     
    Rotavirus                  
     
    Rubella                  
     
    Tetanus                  
     
    Whooping cough (pertussis)                  
     
    Annual flu+      
     

     

     

     

     

     
    The influenza vaccine is recommended annually for all people aged 6 months and over. Influenza vaccine is funded under the NIP for those at or above 6 months of age with certain medical conditions and for Aboriginal and Torres Strait Islander people aged 6 months to under 5 years and those aged at or above 15 years. Learn more about who should receive flu vaccination.
    • 34
    • 4
    • 5
  • If you are aged 50 years or over and have not received a booster dose of the diphtheria vaccine in the past 10 years, it’s recommended that you get one. If you are planning on becoming pregnant, please discuss with your doctor whether immunisation against diphtheria is appropriate for you. 

    Diphtheria is given as part of a combined immunisation that also helps to protect against other diseases.

    Immunisation schedule

    •  Immunisation funded via the National Immunisation Program (NIP) 
    •  Immunisations may be recommended by experts but is not funded
    Diseases All adults Planning for a baby Pregnancy 65 and over 70 to 79 years Aboriginal & Torres Strait Islander adults
    Chickenpox (varicella)            
     
    Diphtheria            
     
    Hepatitis B            
     
    Measles            
     
    Meningococcal ACWY disease            
     
    Meningococcal B disease            
     
    Mumps            
     
    Pneumococcal disease+            
    Pneumococcal vaccine is recommended and funded for Aboriginal and Torres Strait Islander peoples at 50 years of age, with a second dose recommended five years later. All non-Indigenous people can receive a free vaccine at 65 years of age. Women planning pregnancy who have risk factors for pneumococcal disease, including smokers and Aboriginal and Torres Strait Islander women, should be assessed for pneumococcal vaccination.
    Rubella            
     
    Shingles (Herpes zoster)+            
    The herpes zoster (shingles) vaccine is funded for adults aged 70 years, with a short-term catch-up program for adults aged 71-79. It is also recommended (but not funded) for all adults over 60 years of age.
    Tetanus            
     
    Whooping cough (pertussis)            
     
    Annual flu+            
    The influenza vaccine is recommended annually for all adults, and is funded for pregnant women (during any stage of pregnancy), people aged 65 and over, people with certain medical conditions and Aboriginal and Torres Strait Islander peoples.
    • 4
    • 5
  • If you’re travelling overseas, make sure that you are up to date with your diphtheria immunisations. Diphtheria is usually included in combination vaccines that are given to travellers to help protect against diseases such as tetanus and pertussis.

    It is important to plan ahead and see your doctor at least 6 to 8 weeks before you travel to discuss immunisation and travel health.

Treatment

Without treatment, diphtheria can cause life-threatening complications. If suspected, treatment should begin immediately in hospital. The goal of diphtheria treatment is to neutralise the toxin produced by the bacteria. An antitoxin is given along with antibiotics to help kill and remove diphtheria bacteria from your body. Other treatments may be required depending on the severity of the infection.

Patients infected with diphtheria need to be kept in isolation until they are no longer infectious.

Important information

For further information about diphtheria immunisation in your area, speak to your doctor.

Some side effects may be experienced following immunisation. Please discuss any side effects or concerns with your doctor.

AUS/VAC/0073/18 Date of Approval: November 2018