I work in a village where children with fever come for primary health care. 1. In some children especially in infants neither throat inspection can be done even during crying due to tongue nor can they talk to complain of throat pain.

2.Is it a must to somehow inspect (may be by using a tongue depressor) throat in infants & children to rule out diphtheria even if they are  properly  vaccinated ? What do you think about this issue?