The rising rate of Diphtheria disease in the country is alarming. It’s a clear indication that more attention needs to be given to its causes and for proper public health schemes to be set in place to aid prevention of its re-emergence.
An outbreak of diphtheria was first reported in late December 2022, this report was taken from cases seen in Kano state, and by February 2025, there have been approximately 25,000 reported cases and about 1,264 deaths affecting upwards of 11 states including Lagos, Osun and FCT.
Knowing this, it’s not an unlikely idea that you’ve probably come across a case of diphtheria (if you work in a hospital or in a community pharmacy), or even when commuting. So, let’s explore what diphtheria really is, how you can identify it, and what you should do when you think someone you know might have it.
Remember: As a pharmacist, you’re the first line of care for most patients in your environment.
What is Diphtheria?
Diphtheria is a communicable disease which is caused by Corynebacterium diphtheria. It is very contagious and it spreads when you make direct contact with an infected skin, contaminated objects (that harbors the micro-organism), or through the air by respiratory droplets from infected persons (breathing in an infected person’s sneeze).
It affects primarily the nose and throat (the upper respiratory tract), but the exotoxins produced by Corynebacterium diphtheria can also damage the heart, nervous system and integumentary system.
Diphtheria affects anyone who has not been vaccinated against diphtheria or who received an incomplete dose of diphtheria vaccine during vaccination.
Symptoms of Diphtheria
Typically, symptoms begin to manifest after 2 – 5 days of contraction.
It usually begins mildly before turning into complicated symptoms that are usually life threatening.
Here are the things you should be looking out for:
- Sore throat
- Fever of about 39℃ and chills
- Presence of thick greyish membrane found in the throat that covers the pharynx, nostrils, thereby causing obstruction in passage of air, leading to difficulty in breathing and swallowing
- Presence of enlarged lymph nodes in the neck causing swollen glands.
- Open sores on the skin
- Pain, swelling, redness and rashes with scales on the skin
Note: Complicated symptoms occur when the toxins released by the causative organism get to the bloodstream. The released toxins kill the tissue of organs affected and may result in kidney failure, heart muscle damage, (Myocarditis) or Neuropathy (nerve damage).
What’s causing the resurgence of Diphtheria in Nigeria?
With the recent outbreak of diphtheria disease, there’s a need to identify the causes of its resurgence. Some of the things that have been identified includes:
- Lack of vaccination
- Incomplete vaccination: In cases of administration of incomplete dose of diphtheria vaccine, there is an increased tendency of acquiring diphtheria upon exposure to an infected person or outbreak.
- Poor health infrastructures and inadequate health professionals assigned to a particular location: Places affected by natural disasters and conflict can experience obstruction to administration of vaccines, poor health care facilities or inadequate health professionals in that region, thereby creating gaps in routine immunization for inhabitants of such regions.
- Low standard of living and over populated places with poor sanitation.
How can you curb its spread?
Obviously, no one person can stop the spread of diphtheria. But as a collective, especially within the healthcare community, we can do a lot. And pharmacists, as the most accessible healthcare professionals, have a real role to play here.
1. Push Vaccination, Relentlessly
Vaccination is the first line of defense. You know a mother that just gave birth? Talk to them about the vaccine.
You and every pharmacist should make it a point to educate patients about diphtheria vaccines, who needs them, when they need them, and why they’re essential.
You already interact with caregivers, parents, and adults daily, so use that. Ask about immunization status. Encourage completion of vaccine schedules. Explain that incomplete doses don’t offer full protection.
Combinations to know and promote:
- DTaP / Tdap: Diphtheria, Tetanus, and Pertussis: typically for infants, children, and adolescents.
- Td: Tetanus and Diphtheria, especially for adults who can’t take pertussis-containing vaccines.
Immunization Schedule Overview (know this):
- Infants/Children: DTaP at 2, 4, 6 months → booster at 15–18 months → final dose at 4–6 years
- Adolescents: Tdap at 11–12 years
- Adults: Td booster every 10 years
- Travellers: Tdap/Td booster if it’s been over 10 years and they’re heading to high-risk areas
2. Identify, Refer, and Educate
Pharmacists are often the first stop for sore throats, coughs, and fevers — symptoms that can easily overlap with diphtheria in early stages. While diagnosis isn’t your job, suspicion is.
If you spot red flags, especially in under-immunized patients, refer them immediately. Don’t wait.
Also, use every interaction as a teaching moment: reinforce hygiene, share simple facts about the disease, and bust myths when you hear them.
3. Support Treatment and Adherence
If a patient is being treated for diphtheria (or exposed to a case), pharmacists can support with counselling on antibiotics like erythromycin or penicillin, dosing, side effects, and adherence. This is where pharmaceutical care matters.
4. Lead Public Health Conversations in Your Community
You don’t need a mic or a fancy campaign to lead public health education. Talk to your customers. Post info on your pharmacy wall. Join local health outreach programs.
People trust pharmacists, use that trust to spread awareness about diphtheria, the importance of vaccines, and how it spreads.
5. Stay Updated, Stay Ready
The NCDC, Federal Ministry of Health, WHO, and UNICEF are already working to contain the outbreak, but local-level awareness and action is what makes national impact possible. Keep an eye on updates. Understand how Rapid Response Teams work. Know your role if cases rise in your area.
Pharmacists Are Frontline Gatekeepers
As a pharmacist in Nigeria, you’re not just dispensing medicine, you’re shaping public health outcomes every single day. With the right information, proactive communication, and a hands-on approach, you can help stop diphtheria in its tracks. It’s not about doing everything, it’s about doing what you can, where you are, with what you know.
Let’s step up. Let’s do our part.
The writer of this article is a Lagos Young Pharmacist; Victoria Iwu