Why diphtheria shouldn’t be treated at home – Epidemiologists

Public health physicians and infectious disease experts have warned that people suspected of having diphtheria require immediate medical attention at health facilities and should not be managed or treated at home.

They explained that the bacterium produces a toxin that can obstruct the airway and damage the heart, kidneys and nerves.

The epidemiologists noted that suspected cases require diphtheria antitoxin to neutralise the toxin and antibiotics to eliminate the bacteria, warning that home treatment or use of unprescribed antibiotics could delay urgently needed hospital care.

In exclusive interviews with PUNCH Healthwise, the physicians advised Nigerians to seek immediate medical attention if a child or anyone around them develops a sore throat, persistent fever, swollen neck, difficulty breathing, or a grey or white coating in the throat.

They further stated that low or incomplete vaccination coverage was a major driver of the resurgence and urged Nigerians to prioritise immunisation, strengthen active surveillance and intensify community education.

The epidemiologists also called for increased availability of diphtheria antitoxin, stressing that the disease is preventable and treatable when patients receive appropriate intervention promptly.

PUNCH Healthwise reports that Nigeria had recorded more than 12,000 suspected cases, over 10,000 confirmed cases and more than 400 deaths as of August, describing the situation as a sustained resurgence of the vaccine-preventable disease.

Reports shows that there have been increased diphtheria cases over the past three to four years, with major surges recorded in 2024 and 2025. However, between July and September 2026, outbreaks have been recorded in Kano, Katsina, Niger and Plateau states.

In August, PUNCH Healthwise reported that the Federal Teaching Hospital, Katsina, had run out of bed space due to the outbreak, while the state government intensified its response as diphtheria spread to 29 LGAs.

In September, it was reported that 17 deaths had been confirmed among 124 established cases recorded between January and early August 2026 in Niger State.

A few days into September, the diphtheria outbreak worsened and killed 27 in Plateau State, bringing suspected cases in the state to 303 and 27 deaths.

PUNCH Healthwise earlier reported that although fully vaccinated children may develop diphtheria, vaccination substantially reduces severe disease, complications and death.

Providing expert insight into the matter, a Professor of Public Health and Epidemiology at Ahmadu Bello University, Zaria, Kaduna State, Aisha Abubakar, warned Nigerians against delaying hospital treatment for suspected diphtheria, noting that the bacterial infection can progress rapidly and become life-threatening.

The public health physician and infectious disease epidemiologist said Nigeria had recorded more than 12,000 suspected cases, over 10,000 confirmed cases and more than 400 deaths as of August, describing the current outbreak as a sustained resurgence of the vaccine-preventable disease.

She said the recent increase in diphtheria cases had persisted over the past three to four years, with a significant surge recorded in 2024 and 2025, while cases were rising again this year.

Abubakar exclusively told PUNCH Healthwise that the major danger posed by diphtheria was the toxin produced by the bacteria, which could cause severe illness within a short period.

“Diphtheria is a bacterial infection. The disease can progress very rapidly because the bacteria produce a toxin that can cause severe illness, including airway obstruction and potentially death.”

She explained that the treatment of suspected diphtheria required immediate medical intervention, including the administration of diphtheria antitoxin to counter the effects of the toxin and antibiotics to eliminate the bacteria.

The epidemiologist strongly warned against home treatment of the condition, stating that the rapid progression of the disease could affect and cause damage to the heart, kidneys and nerves.

“When you get to the hospital, you are given the antitoxin to counteract the effect of the toxin, and then you are given antibiotics to kill the bacteria. But when you do home treatment, it delays the institution of treatment.”

“Diphtheria affects the throat and mucous membranes; it can cause airway obstruction. So the child or person infected cannot breathe properly. It also affects the heart and leads to abnormal nerve function. It causes damage to the kidneys; it can cause mental problems and nerve damage, and really severe disease is mostly fatal,” she said.

She further noted that children were most commonly affected, especially those who had not been vaccinated, although unvaccinated people in other age groups could also contract the infection.

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Abubakar urged parents and caregivers to take children to the hospital immediately if they suspected diphtheria, rather than waiting for symptoms to worsen or attempting treatment at home.

She further emphasised that early diagnosis and treatment are key to survival.

The infectious disease epidemiologist noted, “Immediately they suspect a child has bacteria, they should take the child to the hospital so that the child can receive the antitoxin as well as the antibiotic. Because when a child develops a sore throat, fever, a swollen neck, difficulty in breathing, or a gray or white coating in the throat, the child needs urgent treatment.”

The leading epidemiologist identified low or incomplete vaccination coverage as the major driver of the current resurgence, explaining that diphtheria outbreaks were less likely when a sufficiently high proportion of the population was immune.

“Diphtheria is a vaccine-preventable disease, and the major driver of this infection is low or incomplete vaccination coverage. There’s what is called herd immunity: if 85 per cent of people are immune, mainly by vaccination, then it’s unlikely that an outbreak will occur. But when we’re having very low vaccination coverage, infected people can infect susceptible people, and then we have a wide-scale outbreak.”

The public health physician further noted that misconceptions about vaccine safety, disrupted health services and difficulties accessing vaccination and healthcare in some communities were also contributing to the problem.

The don stressed that despite the potential severity of the infection, diphtheria was both preventable and treatable when appropriate measures were taken promptly.

“But the sad part is that diphtheria is preventable and treatable. But its major disadvantage is that it can become life-threatening quickly. I mentioned it affects the heart; it affects respiration, so people are unable to breathe.”

Abubakar therefore advised Nigerians to avoid self-medication and seeking antibiotics from pharmacies or patent medicine stores when diphtheria was suspected, insisting that suspected cases should be taken directly to a hospital.

“So I would say that suspected cases are meant to be taken to the hospital immediately. No home management, no going to the pharmacy, to the patient medical store to receive antibiotics. Please take the child straight to the hospital.”

She also called for increased availability of diphtheria antitoxin to ensure that affected patients could receive timely treatment.

“And we also are pleading to have more antitoxins available, so that people can be saved,” Abubakar stated.

Also speaking, a Public Health Physician and Epidemiologist at the Lagos University Teaching Hospital, Idia-Araba, Mushin, Professor Adebayo Onajole, stated that while early symptoms of diphtheria may appear similar to common illnesses such as malaria and flu, immediate medical attention must be sought when symptoms persist.

The epidemiologist stressed that prevention remained the first level of protection against the bacterial infection, identifying immunisation as a key measure for preventing diphtheria.

He explained that the bacteria primarily affects the mucous membrane of the throat, which can compromise the respiratory system and result in severe illness, especially among children.

Onajole said the similarity between the early symptoms of diphtheria and other common illnesses could make it difficult to recognise the infection early, making prompt medical attention important.

The epidemiologist further advised people not to ignore an unresolved rise in body temperature, saying persistent symptoms should prompt them to seek professional help.

“Diphtheria bacteria tends to affect the mucous membrane of the throat, and because of that it affects the respiratory system, and that is why for a lot of people, especially for children, it tends to lead to death. But the earliest symptoms that they tend to have are not much different from ordinary malaria or common flu. Because of that, you must seek medical help when there is unresolved fever,” he noted.

The public health physician said the management of diphtheria required medical interventions that could not be provided at home, including assisted respiration, antibiotics and rehydration.

On prevention, Onajole reiterated the importance of immunisation and other public health measures, including active surveillance and educating communities about the symptoms of the disease.