What is diphtheria? What are symptoms of disease and is there a vaccine - Manston outbreak explained

An outbreak of diphtheria has been reported at the Manston migrant processing centre in Kent. Fifty instances of the disease have been linked to the site in recent months, but what is diphtheria and what are the symptoms? Here’s what you need to know.

What is diphtheria?

Diphtheria is a highly contagious infection that affects the nose and throat, and sometimes the skin. According to the NHS, it’s rare in the UK but there’s a small risk of catching it if you travel to some parts of the world.

What has happened at Manston?

On Saturday (26 November), the Home Office said one person at Manston may have died from diphtheria. This comes after 50 instances of the condition have been reported in recent weeks despite official health data only recording one case near the centre.

The data is published by the UK health security agency (UKHSA), who said the figures relate to cases reported by doctors. However, Home Office sources said all those screened for suspected diphtheria had been seen by Home Office medics, who are A&E doctors.

Nine other cases have been recorded in this published data in the past few months including in Manchester, Eastbourne and Southampton.

Andy Baxter, the assistant general secretary of the Prison Officers Association, which has members working at the site, told The Guardian: “We have consistently raised concerns around the presence of diphtheria at Manston, concerns around the infection control within the facility, and concerns that people were being moved to hotels and onward accommodation without being tested. This failure to test will have seen infected people moved into our communities.”

What are the symptoms of diphtheria?

Symptoms usually start two to five days after becoming infected and include:

• a thick grey-white coating that may cover the back of your throat, nose and tongue
• a high temperature (fever)
• sore throat
• swollen glands in your neck
• difficulty breathing and swallowing

In countries with poor hygiene, infection of the skin - known as cutaneous diphtheria - is more common. If it’s cutaneous diphtheria, it can cause:

• pus-filled blisters on your legs, feet and hands
• large ulcers surrounded by red, sore-looking skin

How is diphtheria spread?

Diphtheria is a highly contagious bacterial infection which spreads by coughs and sneezes, or through close contact with someone who is infected. You can also get it by sharing items, such as cups, cutlery, clothing or bedding, with an infected person.

When should I seek advice?

Diphtheria needs to be treated quickly in hospital to help prevent serious complications, such as breathing difficulties or heart problems.

You should get urgent medical help if you have symptoms of diphtheria and:

• you’re in an area of the world where the infection is widespread
• you have recently returned from somewhere where the infection is widespread
• you have been in close contact with someone who has diphtheria

How is diphtheria treated?

The main treatments are:

• antibiotics to kill the diphtheria bacteria
• medicines that stop the effects of the harmful substances (toxins) produced by the bacteria
• thoroughly cleaning any infected wounds if you have diphtheria affecting your skin

Treatment usually lasts two to three weeks. Any skin ulcers usually heal within 2 to 3 months, but may leave a scar. People who have been in close contact with someone who has diphtheria may also need to take antibiotics, or may be given a dose of the diphtheria vaccination.

Is there a vaccination?

Diphtheria is rare in the UK because babies and children have been routinely vaccinated against it since the 1940s.

The best way to avoid diphtheria while travelling is to be fully vaccinated against it. If you’re travelling to a part of the world where there may be a risk of diphtheria, you may need a booster vaccination if you were last vaccinated against it more than 10 years ago. Since 2018, the World Health Organization has reported a rise in cases of diphtheria in places including Indonesia, India, South America and Africa.

The NHS website says you may be able to get a combined vaccine against diphtheria, tetanus and polio free on the NHS. You can ask about this at a GP surgery.