There may be difficult breathing and a one sided bloody nasal discharge. The patient looks sicker than expected. Some people have the bacteria in the throat without the disease and are called carriers. Patients are more contagious than carriers but carriers keep the disease alive. The poison can cause a fast heart or a paralyzed palate with fluids regurgitated through the nose.
Death is from membrane blockage of the air passages or from the poisoned heart muscle.
Diphtheria has occurred in the former Soviet Union. In 1955 there were 104,000 cases. In 1994 there were 47,808 cases. Russian Diphtheria first occurred in 1980-1989 during the civil war in Afghanistan. About 100,000 soviet troops were demobilized from Afghanistan.