The Times Australia
The Times World News

.

Diphtheria is back in Australia, here's why – and how vaccines can prevent its spread

  • Written by Frank Beard, Associate professor, University of Sydney
Diphtheria is back in Australia, here's why – and how vaccines can prevent its spread

An unvaccinated toddler from the far north coast of New South Wales is in intensive care[1] after catching respiratory diphtheria (diphtheria of the throat). A six-year-old close family contact is also infected.

These are the first cases of respiratory diphtheria in children seen in Australia since 1992[2].

What is diphtheria and how is it spread?

Diphtheria is a potentially deadly infection caused by toxins produced by certain strains of Corynebacterium bacteria.

Respiratory diphtheria causes severe swelling[3] of the throat and neck, which can block the airway and cause breathing problems.

The bacterial toxin can also damage the heart, kidneys, brain and nerves. The bacteria can also cause skin sores[4], which are not as serious as respiratory diphtheria.

The diphtheria bacteria spread through respiratory droplets, for example, from coughing or sneezing. They can also spread through touching skin sores.

How is it prevented?

In Australia, vaccines containing diphtheria toxoid (an inactivated form of the toxin) are provided free on the National Immunisation Program[5] (NIP), with three doses initially at two, four and six months of age.

These are six-in-one combination vaccines which also provide protection against pertussis (whooping cough), tetanus, polio, hepatitis B and Haemophilus influenzae type b[6] (Hib) infection, which causes meningitis (inflammation of the lining of the brain) and septicaemia (blood poisoning).

Read more: Have you had your diphtheria vaccines? Here's why it matters[7]

Booster doses for diphtheria, tetanus and pertussis are provided under the National Immunisation Program at 18 months, four years and at around 12 years of age (through school-based immunisation programs). It’s important to get all these booster doses as immunity tends to decrease over time.

Adult boosters are also recommended but not funded by the National Immunisation Program.

How is it treated?

Antibiotics are given to people with diphtheria but may not have much impact on the disease once established.

Specialised treatment with diphtheria antitoxin (DAT) is often required to counteract the effects of the toxin. DAT needs to be given early in the illness (within 48 hours).

However there are global shortages[8] of DAT due to decreased production over recent decades.

It was once a big killer

Diphtheria was once among the top-ten causes of child death[9]. There were more than 4,000 deaths[10] from diphtheria in Australia between 1926 and 1935.

Diphtheria cases fell dramatically following the introduction of vaccines in the 1940s.

Child touches their sore neck
Diphtheria respiratory infection causes swelling of the throat and neck. Shutterstock[11]

Diphtheria is now rare. Prior to the two recent cases in NSW, there had been no cases of respiratory diphtheria in children in Australia since 1992. There were 38 cases of skin diphtheria reported between 2011 and 2019, affecting both children and adults. Over the same period, there were seven cases of respiratory diphtheria, all of which were in adults. Two unvaccinated adults died from respiratory diphtheria in 2011[12] and 2018[13].

Why are we seeing diphtheria now? What role does travel play?

Anyone unvaccinated against diphtheria is at risk of disease. Diphtheria vaccination rates in Australian children have been high at over 90% since 2000 and are currently around 95%[14].

People born before 2000 are more likely to be under-vaccinated, as vaccination rates were lower when they were growing up.

Read more: Health Check: which vaccinations should I get as an adult?[15]

There is also a particular risk from travel to countries where diphtheria remains more common, including Southeast Asia, Papua New Guinea, states of the former Soviet Union and eastern European countries.

Diphtheria vaccination prevents disease but doesn’t fully prevent people carrying the bacteria in the back of their throat without symptoms. It is possible for fully vaccinated people to spread the bacteria to unvaccinated contacts, including when they return from overseas travel.

Increases in diphtheria are a now a real risk as vaccination rates have declined globally[16].

We are also at increased risk of other diseases, such as measles, now international travel has restarted. Measles cases have surged globally in part due to COVID pandemic-related disruption[17] to routine immunisation programs in many parts of the world. UNICEF and the World Health Organization have warned[18] of a perfect storm of conditions for measles outbreaks.

A recent measles case[19] in a traveller was the first in Australia since March 2020.

What can you do?

Ensuring people of all ages are up-to-date with their vaccines is key.

Parents should ensure children get all their routine vaccinations on time – this will provide strong protection against serious diseases like diphtheria and measles.

Nurse vaccinates toddler
Vaccines provide strong protection against diphtheria. Shutterstock[20]

People of all ages should also be up-to-date for vaccines, particularly if travelling overseas. Beyond childhood, the Australian Immunisation Handbook[21] recommends a diphtheria vaccine booster dose for:

  • adults at 50 and 65 years of age

  • people of any age who are more than ten years since their last dose and travelling to a country where health services are difficult to access.

  • people travelling to high-risk countries if it has been more than five years since the last dose.

Ensuring support to low- and middle-income countries, particularly those in our region, to strengthen their immunisation programs, including via catch-up campaigns for measles and other vaccines, is also key to protecting us all.

Read more: Diphtheria could become a problem again thanks to new variants and antimicrobial resistance[22]

References

  1. ^ intensive care (www.abc.net.au)
  2. ^ since 1992 (www1.health.gov.au)
  3. ^ severe swelling (www.cdc.gov)
  4. ^ skin sores (www.nejm.org)
  5. ^ National Immunisation Program (www.health.gov.au)
  6. ^ Haemophilus influenzae type b (www.health.gov.au)
  7. ^ Have you had your diphtheria vaccines? Here's why it matters (theconversation.com)
  8. ^ global shortages (www.ijidonline.com)
  9. ^ child death (historyofvaccines.org)
  10. ^ more than 4,000 deaths (www1.health.gov.au)
  11. ^ Shutterstock (www.shutterstock.com)
  12. ^ 2011 (www.smh.com.au)
  13. ^ 2018 (www.sbs.com.au)
  14. ^ currently around 95% (ncirs.org.au)
  15. ^ Health Check: which vaccinations should I get as an adult? (theconversation.com)
  16. ^ declined globally (www.thelancet.com)
  17. ^ COVID pandemic-related disruption (theconversation.com)
  18. ^ have warned (www.who.int)
  19. ^ recent measles case (www.health.vic.gov.au)
  20. ^ Shutterstock (www.shutterstock.com)
  21. ^ Australian Immunisation Handbook (immunisationhandbook.health.gov.au)
  22. ^ Diphtheria could become a problem again thanks to new variants and antimicrobial resistance (theconversation.com)

Read more https://theconversation.com/diphtheria-is-back-in-australia-heres-why-and-how-vaccines-can-prevent-its-spread-186348

Times Magazine

Building a Strong Online Presence with Katoomba Web Design

Katoomba web design is more than just creating a website that looks good—it’s about building an online presence that reflects your brand, engages your audience, and drives results. For local businesses in the Blue Mountains, a well-designed website a...

September Sunset Polo

International Polo Tour To Bridge Historic Sport, Life-Changing Philanthropy, and Breath-Taking Beauty On Saturday, September 6th, history will be made as the International Polo Tour (IPT), a sports leader headquartered here in South Florida...

5 Ways Microsoft Fabric Simplifies Your Data Analytics Workflow

In today's data-driven world, businesses are constantly seeking ways to streamline their data analytics processes. The sheer volume and complexity of data can be overwhelming, often leading to bottlenecks and inefficiencies. Enter the innovative da...

7 Questions to Ask Before You Sign IT Support Companies in Sydney

Choosing an IT partner can feel like buying an insurance policy you hope you never need. The right choice keeps your team productive, your data safe, and your budget predictable. The wrong choice shows up as slow tickets, surprise bills, and risky sh...

Choosing the Right Legal Aid Lawyer in Sutherland Shire: Key Considerations

Legal aid services play an essential role in ensuring access to justice for all. For people in the Sutherland Shire who may not have the financial means to pay for private legal assistance, legal aid ensures that everyone has access to representa...

Watercolor vs. Oil vs. Digital: Which Medium Fits Your Pet's Personality?

When it comes to immortalizing your pet’s unique personality in art, choosing the right medium is essential. Each artistic medium, whether watercolor, oil, or digital, has distinct qualities that can bring out the spirit of your furry friend in dif...

The Times Features

NSW has a new fashion sector strategy – but a sustainable industry needs a federally legislated response

The New South Wales government recently announced the launch of the NSW Fashion Sector Strategy, 2025–28[1]. The strategy, developed in partnership with the Australian Fashion ...

From Garden to Gift: Why Roses Make the Perfect Present

Think back to the last time you gave or received flowers. Chances are, roses were part of the bunch, or maybe they were the whole bunch.   Roses tend to leave an impression. Even ...

Do I have insomnia? 5 reasons why you might not

Even a single night of sleep trouble can feel distressing and lonely. You toss and turn, stare at the ceiling, and wonder how you’ll cope tomorrow. No wonder many people star...

Wedding Photography Trends You Need to Know (Before You Regret Your Album)

Your wedding album should be a timeless keepsake, not something you cringe at years later. Trends may come and go, but choosing the right wedding photography approach ensures your ...

Can you say no to your doctor using an AI scribe?

Doctors’ offices were once private. But increasingly, artificial intelligence (AI) scribes (also known as digital scribes) are listening in. These tools can record and trans...

There’s a new vaccine for pneumococcal disease in Australia. Here’s what to know

The Australian government announced last week there’s a new vaccine[1] for pneumococcal disease on the National Immunisation Program for all children. This vaccine replaces pr...