Diphtheria: is your child protected?
Publication Date:12/05/2008
Doctors are advising parents to check their children are up to date with their vaccinations after a child in London recently died from what experts think was diphtheria. Although diphtheria is very rare in the UK, you can get it if you're not immunised and you travel to countries where it is more common.
What is diphtheria?
Diphtheria is an infection that is caused by bacteria. It mainly affects the throat and nose, although sometimes it can invade the skin and eyes.
Diphtheria causes a sore throat, fever, swollen lymph glands and breathing problems. If the bacteria infect the skin they can cause a sore (ulcer) that doesn't heal. There are different strains of the bacteria that cause diphtheria and some are more dangerous than others. Strains of the bacteria that produce a poison (toxin) can damage the heart and nervous system, and in serious cases this can be fatal.
The bacteria that cause diphtheria spread easily from an infected person through tiny droplets in coughs and sneezes. Anyone who has not been immunised and has been in contact with someone with diphtheria is at risk of contracting the disease.
How common is it?
Diphtheria is extremely rare in the UK because most people have been immunised against it.
The immunisation programme against diphtheria was introduced in the UK in 1942. Before then, 60,000 people in the UK got diphtheria every year and 4,000 people died from the disease. But thankfully very few people in the UK get diphtheria these days.
Since 1982 there have been four deaths from diphtheria in the UK. Three of the people who died were known to have not been immunised and the fourth was also thought to be not immunised. In the last 20 years there have been about another 14 cases of diphtheria, most of them among people who had come back to the UK from countries where diphtheria is common. The last death was a child in 1994 who contracted the disease in Pakistan. It's thought he had not been immunised.
Even though diphtheria is rare in the UK, it is more common in some countries where the vaccine is not widely used or is unavailable, especially in Africa, South Asia and the former Soviet Union. So it's important to make sure your vaccinations are up to date before you travel to these areas.
When is the vaccine given?
All children in the UK are offered a vaccination against diphtheria as part of the childhood immunisation programme. The first dose is given at two months of age followed by two more doses at three and four months. The vaccine also protects against tetanus, pertussis (whooping cough), polio and Haemophilus influenzae type b (Hib). Children get booster doses just before they start school and again between the ages of 16 and 18.
How effective is the vaccine?
The vaccine is very effective and if you get all the recommended doses you're extremely unlikely to get the disease.
Since 2001, 94 percent of children in the UK have been vaccinated against diphtheria. But in some parts of the country, vaccine uptake is lower. In London, only 86% of children have had the required number of doses. High uptake is important because the fewer children who can catch the disease the less likely it is that diphtheria will spread to other people and become a problem in this country again.
How is diphtheria treated?
Diphtheria is treated with an antitoxin and antibiotics to get rid of the bacteria. When the person recovers they'll also be given the vaccine, as it is possible to get diphtheria more than once.
Anyone who has been in contact with someone with diphtheria is given antibiotics and a booster vaccine to prevent infection.
What is the latest advice?
Doctors have advised people who are not up to date with their routine immunisations to contact their GP to arrange them. Parents should check that their children's vaccinations are up to date. If you're unsure whether you or your child have had all the recommended vaccines, check with your GP.
The advice follows the death of a child in London from what doctors think was diphtheria. The child had not been immunised. Close contacts of the child have been given preventive treatment.
Who has issued the advice?
The latest advice is from the Health Protection Agency, an independent body that is responsible for protecting the UK public against infectious diseases.
What should I do now?
Check that your child's immunisations are up to date. Most children have a personal child health record that you keep at home. Your child's immunisations are recorded in this book and you should be able to see if they are up to date. If you're not sure whether your child has had all their recommended vaccines, then ask your GP or health visitor to check their records.
Adults can also check with their GP to find out if they have been immunised. It's important to check you are protected against diphtheria if you're due to travel to Africa, South Asia or the former Soviet Union. Your GP can do a test if you're not sure whether you have had been immunised.
From:
Health Protection Agency. Death of a child infected with diphtheria in London. May 2008. Available at http://www.hpa.org.uk/web/home (accessed on 11 May 2008).
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This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
