Diphtheria is an infection caused by a bacterium called Corynebacterium diphtheriae that causes a moderately sore throat. Sometimes the lining of the throat may swell to form "a false membrane" which can cause difficulties in breathing. Tetanus is a potentially fatal disease which is caused by a bacterial infection, usually contracted through a small wound or scratch, from where the bacteria can enter the body and grow to produce a powerful toxin which circulates in the blood. Poliomyelitis, most commonly referred to as polio and is caused by a virus which is primarily spread through faecal contamination of food and water, although it can also be spread by droplet transfer.
Diphtheria is mainly spread by droplets expelled from the nose and mouth usually by breathing in diphtheria bacteria after an infected person has coughed, sneezed or even laughed. It can also be spread by handling used tissues or by drinking from a glass used by an infected person.
Nearly one out of every ten people who get diphtheria will die from it. Most cases occur among unvaccinated or inadequately vaccinated people. However, whether or not the patient dies depends on the severity of the illness, their level of immunity and the speed with which treatment is started.
One of the regions where diphtheria is present is eastern Europe, including Russia and the former states of the Soviet Union. Cases of have occurred in Finland, Estonia, Poland and Belarus and even Germany, Belgium and the UK resulting from imported infection.
Diphtheria can be prevented with a safe and effective vaccine. A vaccine is now available for travellers to provide protection against both diphtheria, tetanus and Polio. However, travellers are also advised to avoid close contact with people in crowded places when travelling in endemic regions (particularly kissing and sharing bottles or glasses). Immunisation is very effective and UK children are immunised within their first year. Boosters are required every 10 years for travellers and those at risk.
Tetanus can quite easily be contracted through a small wound or scratch, from where the bacteria can enter the body and grow to produce a powerful toxin which circulates in the blood, causing muscular rigidity and painful muscle contractions. Death is usually caused by respiratory problems and exhaustion.
While vaccination has largely diminished the incidence of tetanus, the disease has not disappeared. Tetanus can be found all over the world and so every traveller should fully protect themselves against tetanus. Any type of injury from a simple laceration to a more serious wound can expose the individual to the spores. If individuals are not fully immunised there is always the risk of tetanus developing in wounds contaminated by soil. Immunisation against tetanus is highly protective and adults and children should ensure they are fully up to date with their vaccination program. Booster doses should be administered at ten year intervals.
The combined diphtheria/tetanus/polio vaccinations are now normally used when any of these vaccinations are required.
A Polio infection of the gut can spread to the spinal cord or brain where it can cause paralysis.
Those travelling to areas of the world where polio still occurs. ie. Nigeria, Niger, India, Pakistan and Afghanistan are particularly high risk. The World Health Organisation is making great efforts to encourage widespread use of polio vaccine in an attempt to eradicate polio from all the countries of the world. However, until the disease is certified as eradicated, the risk of acquiring it remains.
Past immunisation from polio does not always give complete protection as there are three strains of the virus and so travellers should ensure they are up to date with their polio immunisation. To ensure further protection try to avoid crowded places in high risk areas as much as possible.
* Please note that vaccine cost is the cost per dose to have the vaccine with a nurse and not a GP. There is an additional fee of £25 for the vaccine to be administered by a GP. Also, the number of doses required indicates the number of doses for a standard course. For instance, an accelerated course can impact the number of doses required.
Cost: £60 per dose
Warning: Revaxis is the combined Tetanus, Diphtheria and Polio Vaccine used by the IGP. It is specifically intended as a booster and should not be given as the primary course and/or to children under the age of 6. The DTP combined vaccine is a provided in a single injection. A booster is required every 10 years.
After having the Diphtheria vaccine, it is common for there to be temporary soreness, redness or swelling at the injection site. A small, painless lump may also form at the injection site, which usually disappears within a few weeks and is no cause for concern. However, details of possible side effects and special precautions should be discussed during the appointment.
Please be aware that for full immunity some vaccination courses, with more than one vaccine required, may take up to a month or longer. Please, also be aware that many vaccinations will not become fully effective until weeks after the course completion. It is strongly advised that you leave plenty of time to complete the course before your trip. Intervals between different vaccines or doses are recommended, which allows time for antibodies to be produced and any reaction to the vaccine to subside.