The Travel Health and Vaccine Specialists

Health Alert


Diphtheria: Global update

Updated June 4, 2018

Updated: May 10, 2018

Information regarding number of cases in affected countries has been updated.
Brazil was removed from the list of countries with reported outbreaks in 2017. Cases that were previously reported were confirmed to be not diphtheria.

Original publication date: February 9, 2018
Where is diphtheria a concern?
Diphtheria occurs worldwide and is still endemic in many countries. Travellers who are not fully vaccinated may be at risk for catching diphtheria when visiting a country where the disease is still prevalent.

Currently, the following countries are reporting outbreaks of diphtheria:

Bangladesh: There is currently an outbreak of diphtheria in the displaced Rohingya population in Cox’s Bazar, Bangladesh and surrounding community. Between November 8, 2017 and March 31, 2018, over 6 460 cases and 40 deaths have been reported in the area.
Haiti: In 2017, there were over 150 cases of diphtheria reported in Haiti. Cases continue to be reported in 2018. The departments of Artibonite, Centre and Ouest are reporting the highest number of cases.
Indonesia: In 2017, there were over 590 cases of diphtheria reported in 20 provinces of Indonesia.
Venezuela: In 2017, there were over 1 278 cases of diphtheria at at least 125 deaths have been reported in Venezuela.
Yemen: Since October 2017, over 1 300 cases and 70 deaths have been reported in Yemen.
What is Diphtheria?
Diphtheria is a very contagious bacterial disease. It can spread quickly from person to person by direct, close physical contact, contact with respiratory droplets, and less commonly, through contact with contaminated objects. Diphtheria can be very serious and even deadly, especially for infants and very young children.

The symptoms of diphtheria include:

sore throat
fever and chills
difficulty breathing
Diphtheria is prevented with immunization.

Diphtheria can be treated with antibiotics as well as with a diphtheria antitoxin.

How can you protect yourself from diphtheria?
Consult a health care provider or visit a travel health clinic six weeks before you travel.

Get vaccinated for diphtheria
Diphtheria can be prevented with a vaccine. In Canada, the diphtheria vaccine is part of the Routine Childhood Immunization Schedule. The diphtheria vaccine is usually given as part of a combined vaccine with other diseases. Travellers should make sure their diphtheria vaccination is up-to-date, regardless of their travel destination:

Infants & Children:
It is recommended that children get four doses of the combined vaccine. These doses are usually given at two months, four months, six months and 18 months of age.
Your child should get a booster vaccine between the ages of four and six years.
Adolescents between 14 to 16 years of age should receive a booster dose of the combined diphtheria and tetanus and pertussis vaccine.
Adults (18 years of age and older):
The diphtheria vaccine should be given every ten years for lasting protection.
Travellers should receive one dose of the diphtheria vaccine if they do not have one of the following:
documented evidence of receiving a vaccine in the past ten years;
laboratory evidence of immunity (e.g. through blood testing); or
a history of laboratory confirmed diphtheria disease.
Wash your hands frequently

Wash your hands often with soap and water for at least 20 seconds.
Use alcohol-based hand sanitizer if soap and water are not available. Carry a bottle of sanitizer with you when you travel.
Practise proper cough and sneeze etiquette:

Cover your mouth and nose with your arm to reduce the spread of germs.
Dispose of tissues as soon as possible after use, and wash your hands.
Monitor your health

See your health care provider if you develop symptoms of diphtheria when travelling or after you return to Canada:
Alert the health care provider about your symptoms before your appointment, so they can take proper precautions
Tell the health care provider which countries you have visited
Avoid close contact with other people to reduce the chance of infecting others if you:
have symptoms of diphtheria
have been exposed to someone who has diphtheria
If you notice symptoms of diphtheria during the flight, tell the flight attendant before you land or the border services officer as you enter the country. They will notify a quarantine officer who can assess your symptoms.
Registration of Canadians Abroad
Sign up with the Registration of Canadians Abroad (ROCA) service to stay connected with the Government of Canada in case of an emergency abroad or an emergency at home.

Related links
About diphtheria
Assistance – Sickness or injury
If you get sick after travelling
Travel Vaccinations
Other Resources
Canadian Immunization Guide, Public Health Agency of Canada, Diphtheria
World Health Organisation – Diphtheria

Date modified: 2017-04-05