Tetanus,Diphtheria,Polio & Pertussis


Tetanus is a unique non-communicable vaccine – preventable disease.  Tetanus spores are found widely in the environment.  The incubation period is usually 3 – 21 days with the majority of cases occurring within 14 days.

How is it transmitted?

Tetanus spores exist in the intestines of humans and other animals.  Transmission is by excretion of human and animal faeces in the soil.  Infection may result when a wound is exposed to contaminated dirt or soil.

What are the signs and symptoms?

Acute manifestations of Tetanus include muscle rigidity and painful spasms often starting in the muscles of the jaw and neck.  Severe Tetanus can lead to respiratory failure and death.


Diphtheria is an acute communicable illness characterized by a membranous inflammation of the upper respiratory tract (nose, pharynx, tonsils, larynx and trachea).  Other sites may also be affected.  The incubation period is 2 – 5 days (range 1 – 10 days).

How is it transmitted?

Diphtheria is transmitted from person-to-person via oral or respiratory droplets.  Close physical contact and sometimes formites.  Humans are the only reservoirs for the disease.

Who is at risk of infection?

Un-immunized or insufficiently immunized persons are at risk of exposure and infection if travelling to countries where the disease is endemic.

What are the signs and symptoms?

Respiratory diphtheria starts gradually and is characterized by a mild fever, sore throat, difficulty in swallowing, malaise, loss of appetite and hoarseness if the larynx or nares and extending into the trachea.  Any attempts to remove it can result in bleeding.  Life-threatening or fatal airway obstruction can also occur.


Poliomyelitis (Polio) is an acute infection caused by any of the three serotypes (1, 2, or 3) of the poliovirus.  The virus initially replicates in the gastrointestinal tract leading to cell destruction and flaccid paralysis of the muscles.  Infection may or may not be symptomatic.  Flaccid paralysis can affect one or all four limbs.  Respiratory failure may also result but rarely death.

How is it transmitted?

Polio is transmitted by person-to-person spread through the faecal-oral route, oral-oral routes or less frequently by a common vehicle, e.g. milk or water.

How can Polio be prevented?

Polio endemic areas or areas where Polio epidemics occur include some countries in Africa, South Asia, South-East Asia and the Middle East.  Your travel health consultant can provide more information.


Pertussis is an acute infectious cough illness caused by a bacterium Bordetella pertussis.  Immunity from childhood vaccination and natural disease wanes with time (5 – 10 years) leaving adolescents and adults susceptible. 

How is Pertussis transmitted?

Pertussis is highly infectious and is transmitted from person-to-person through large respiratory droplets generated by coughing or sneezing.  The usual incubation period is 7 – 10 days.

In which Regions/Countries is Pertussis endemic?

Pertusses remains endemic worldwide even in areas with high vaccination rates.  Close contact with infected person increases the risk of disease.

How serious is Pertussis in adults?

Pertussis in adults ranges from a mild cough (<3 weeks to months) to classic whooping cough or may be asymptomatic.  It can lead to complications, e.g. pneumonia and rib fracture, loss of consciousness has been reported in some adults.

Speak to your travel health consultant about a vaccine for all these diseases.