Symptoms of Diphtheria

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Diphtheria has one of the shortest incubation periods of all infectious diseases and the onset is very sudden. A child may become seriously ill within a day of developing the first symptoms. Symptoms of the disease can start 2-9 days after contact with the infection (the incubation period) and include sore throat, headache, difficulty swallowing and enlarged lymph nodes in the neck.

The germ normally attacks the throat, but in rare cases may involve the skin, especially open wounds or burns. It produces a powerful poison (exotoxin) which is released into the surrounding tissues, killing cells and causing a kind of membrane to be exuded that is formed of clotted serum (fibrin), white cells, bacteria and dead surface-tissue cells.

This throat membrane usually covers the tonsils and is a dirty grey colour. It sticks so firmly to the surface that any attempt to remove it with forceps causes bleeding. The immediate danger from the membrane is to the upper air passages, which may become blocked, necessitating an emergency artificial opening into the windpipe (a tracheostomy).

The neck lymph nodes may be so swollen as to widen the neck, often referred to as bull-neck.