Diphtheria is an infection caused by toxigenic strains of the bacteria Corynebacterium diphtheriae.
Initial symptoms consist of:
- sore throat
- difficulty swallowing
- malaise
- low-grade fever
The pathogen produces a toxin that interferes with cellular processes causing tissue destruction, which in turn causes the most notable symptom of diphtheria, a grayish-white pseudomembrane over the tonsils, pharynx, or larynx. The membrane can cause the airway to become obstructed which can be fatal. The toxin can be absorbed into the bloodstream and can cause damage to tissue throughout the body.
Cases of diphtheria are still seen throughout the world and many of those cases are from southeast Asia.
There has not been a case of diphtheria reported in Arizona in the last 10 years.
Transmission
Diphtheria is spread by respiratory tract droplets and contact with skin lesions. Rarely, fomites and raw milk or milk products can act as a mode of transmission. Fully immunized individuals can act as carriers.
Test*
|
Specimen
|
Culture
|
NP swab
(synthetic only), Throat swab (synthetic only) |
Isolate and institute droplet precautions for a pharyngeal diphtheria case or a suspect case.
Isolate and institute contact precautions for a cutaneous diphtheria case or suspect case.
Prevention for Patients
Vaccination is the best prevention method. >95% of healthy adults and infants, children, and adolescents develop adequate antibody response after a 3-dose series. Tdap booster is recommended for adults in place of the Td booster
Vaccination is the best prevention method. >95% of healthy adults and infants, children, and adolescents develop adequate antibody response after a 3-dose series. Tdap booster is recommended for adults in place of the Td booster
In untreated individuals, the pathogen can be present in discharges for 2 – 6 weeks after infection. In properly treated individuals they will no longer be contagious 48 hours after the treatment
Public Health Actions
Antitoxin is available through the CDC and should be given as soon as possible after diagnosis, even before culture results are determined.
Antitoxin is available through the CDC and should be given as soon as possible after diagnosis, even before culture results are determined.
Cases of diphtheria should be excluded from working as a food handler, caring for patients in a healthcare institution, or caring for children in or attending a school or child care establishment until a set of cultures negative for C. diphtheriaeis obtained from the nose and throat specimen.
Public health will conduct an epidemiological investigation on a case or suspect case.
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