Diphtheria is highly infectious bacterial infection which can be fatal. Diphtheria is typically spread by coughing and sneezing, close contact with infected people or contaminated clothes and bedding. There is a safe and effective vaccine.

Diphtheria can cause nose and throat infections: a tough ‘leathery’ grey/yellow membrane develops, that affects the soft palate, tonsils and throat. Lymph glands become swollen, prominent and tender, producing a ‘bull neck’. Symptoms include sore throat, difficulty and/or pain on swallowing, husky voice, fever, cough, headache and, if there is airway obstruction, breathing difficulties.

Diphtheria can also cause painful, non-healing skin ulcers (cutaneous diphtheria) which often become infected with other bacteria. Severe illness is unusual.

Diphtheria is still a risk for unvaccinated travellers to countries where the uptake of diphtheria containing vaccines in low.


Vaccination is the most effective way to prevent infection. Travellers should ensure they are up to date with their routine vaccines according to the NHS vaccination schedule.

Some types of diphtheria bacteria can spread from animals to humans. Travellers should be advised not to consume raw dairy products, to avoid close contact with cattle/farm animals and to follow good personal hygiene rules to minimise risk of infection.

Specific country diphtheria vaccine recommendations are not routinely provided on TravelHealthPro country pages.

Diphtheria vaccine

The primary UK vaccination course consists of three doses of diphtheria-toxoid containing vaccine at two, three and four months of age. A first booster should be administered at around three years and four months and a second booster between 13 to 18 years of age.

Vaccine schedules

Vaccine Schedule and age range
6-in-1 vaccine: diphtheria, hepatitis B, Haemophilus influenza type b, polio and tetanus (DtaP/IPV/Hib/HepB) Three doses: given at eight, 12 and 16 weeks of age.
4-in-1 vaccine: Diphtheria, tetanus, whooping cough and polio (DTaP/IPV or dTaP/IPV) Single pre-school booster dose: given at three years, four months old or soon after.
Tetanus, diphtheria and polio (Td/IPV) Single booster dose: given at 14 years of age. Also given to adults and children (from 10 years) who need a primary course or travellers require a booster dose.
Diphtheria, tetanus, pertussis and polio (dTaP/IPV) Single booster dose: offered to pregnant women 16 to 32 weeks gestation*
* Recommended for pregnant women between 16 to 32 weeks to protect unborn child against whooping cough (pertussis).

For more information see Public Health England: Immunisation against infectious disease