What is diphtheria, what are the symptoms and how does it spread?

At least 50 cases of diphtheria are thought to have been identified in asylum seekers in England this year, despite the disease being incredibly rare in the UK.

Sky News revealed a man who died after staying in the Manston migrant processing centre in Kent had the illness.

Health officials have now raised concerns that some migrants with suspected diphtheria have been moved from the Manston centre to other parts of the country.

Here, Sky News explains what we know about the infection.

What is diphtheria?

Diphtheria is a highly contagious infection caused by bacteria called Corynebacterium diphtheriae, which produces a toxin that makes people ill.

That toxin kills healthy tissue within the respiratory system, causing problems with the nose and throat.

It can also infect the skin, causing blisters and ulcers.

What are the symptoms?

It takes between two and three days for toxins to start killing respiratory tissue. At this point a thick, grey coating appears inside the nose and throat and causes the following symptoms:

• Difficulties swallowing and breathing
• Sore throat
• Swollen glands in the neck
• High temperature

Diphtheria can spread to the skin, which can also cause:
• Pus-filled blisters on the legs, feet and hands
• Large ulcers surrounded by red, sore skin

In the most severe cases, the toxin can enter the blood stream and cause heart, kidney or nerve damage, even resulting in death – but this is incredibly rare in vaccinated people.

Vaccination

Diphtheria is very rare in the UK as people have been routinely vaccinated against it since the 1940s.

Vaccines are usually combined with tetanus and polio ones. NHS figures for 2021-22 showed uptake at 91.8%.

In the UK, babies are given three doses at eight, 12 and 16 weeks old – then again at three years and four months – before a booster dose at 14.

You can get additional booster jabs if you are travelling to a country where diphtheria is still a risk and your last jab was 10 or more years ago.

Since 2018, the World Health Organisation identified a rise in cases across Indonesia, India, South America and Africa.

Cases among asylum seekers in Europe are thought to have been on the rise since October.

How is it spread?

Infected individuals are highly contagious and can spread the disease by coughing, sneezing, or being in close contact with someone else.

You can also become infected by sharing items with an infected person such as clothing, bedding, cutlery and cups.

How is it treated?

The best way to avoid diphtheria is through vaccination.

Treatments include:
• Antibiotics (which kill the bacteria)
• Medicines that stop the effects of the harmful toxins produced
• Regularly cleaning skin wounds caused by diphtheria

Treatment takes between two and three weeks, but skin ulcers can take two or three months to heal and may leave scars.

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