Diphtheria in Vietnam

Warning - Level 3, Avoid Nonessential Travel
Alert - Level 2, Practice Enhanced Precautions
Watch - Level 1, Practice Usual Precautions

As the COVID-19 situation around the world changes, CDC is monitoring COVID-19 risk in each country and making travel recommendations. If you are considering international travel, see CDC’s COVID-19 Travel Recommendations by Destination.

Key points

  • There is an outbreak of diphtheria in Vietnam.
  • When a person infected with diphtheria coughs or sneezes, they can spread the bacteria to others. People who are unvaccinated or not fully vaccinated against diphtheria can also become very sick if they touch the skin sores of someone with diphtheria skin infection.
  • To prevent diphtheria, all travelers should make sure they are up to date with diphtheria vaccination.
Map showing areas of diphtheria in Vietnam
Map: Diphtheria in Vietnam (see larger map)
What is diphtheria?

Diphtheria is a bacterial disease that causes respiratory tract and skin infections. It can spread from person to person by coughing, sneezing, and through contact with infected skin sores.

Diphtheria bacteria make a toxin (poison) that kills healthy tissues in the respiratory system. Within two to three days, the dead tissue forms a thick, gray coating that can build up in the throat or nose making it very hard to breathe and swallow. If the toxin gets into the blood stream, it can cause heart, nerve, and kidney damage.

Diphtheria skin infections are more common in tropical areas. They are not usually severe. However, people who are unvaccinated or not fully vaccinated against diphtheria can develop serious respiratory tract disease after touching the skin sores of someone with diphtheria skin infection.

What is the current situation?

Health officials in Vietnam have reported an outbreak of diphtheria in the Central Highlands region. In response to the outbreak, the Vietnam Ministry of Health has launched a vaccination campaign for affected provinces and implemented several measures to help prevent and control the spread of the disease.

What can travelers do to protect themselves?

Getting vaccinated is the best way to protect against diphtheria. Diphtheria vaccines are combination vaccines. Some vaccines (DT and Td) protect against diphtheria and tetanus, while others (DTaP and Tdap) also protect against pertussis (whooping cough).

Talk to your doctor if you had a severe reaction after a previous dose of diphtheria, tetanus, and pertussis vaccine. If your doctor advises you to postpone or not receive the vaccine, consider changing or cancelling your travel.

If you get sick during or after travel

  • If you feel sick during travel, seek medical care immediately. Respiratory diphtheria infections can be treated with antitoxin and antibiotics.
  • If you get sick after returning to the United States, seek medical care immediately. Tell your healthcare provider about your travel and that you think you might have been exposed to diphtheria.

What can clinicians do?

CDC recommends diphtheria, tetanus, and pertussis (whooping cough) vaccination for everyone, especially patients traveling to parts of the world where diphtheria vaccines are not used or where few people are vaccinated routinely. Provide diphtheria, tetanus, and pertussis vaccines to overseas travelers according to CDC’s recommendations:

  1. Babies and Children. Babies need three shots of DTaP to build up high levels of protection against diphtheria, tetanus, and pertussis. Young children need two additional booster shots to maintain protection through early childhood. CDC recommends doses at the following ages:
    • 2 months
    • 4 months
    • 6 months
    • 15 through 18 months
    • 4 through 6 years
  2. Adolescents. Preteens should get one shot of Tdap between the ages of 11 and 12 to boost their immunity.
  3. Adults. After adolescence, all adults should get a diphtheria shot every 10 years. Any adult who has never received Tdap should get one shot followed by either a Td or Tdap shot every 10 years. Vaccine providers can give Tdap to an adult who has never received it at any time, regardless of when they last got Td.

Traveler Information

Clinician Information

This notice was originally posted October 6, 2020.