Diphtheria

Cause: Toxigenic strains of the bacterium Corynebacterium diphtheriae.

Illness and treatment: Classic diphtheria is an upper-respiratory tract illness characterized by sore throat, low-grade fever, and an adherent membrane of the tonsil(s), pharynx, and/or nose, sometimes with neck swelling. Diphtheria can involve almost any mucous membrane and may also be cutaneous. Treatment is with antitoxin, antibiotics, and supportive care.

Sources: Humans carriers are the reservoir and are usually asymptomatic. Transmission is through respiratory droplets, but may occur from skin lesions or articles soiled with discharges.

Additional risks: Susceptible travelers to areas where routine immunization of adults is lacking are at higher risk for diphtheria infection, especially if an epidemic is in progress.

Prevention: Universal immunization including booster doses prevents infection. Respiratory and hand hygiene prevent transmission.

Recent Washington trends: The last recorded case was in 1981.

Purpose of Reporting and Surveillance

To assist in the diagnosis of cases
To assure early and appropriate treatment with diphtheria antitoxin and antibiotics
To identify and evaluate contacts and recommend appropriate antibiotic prophylaxis and/or immunization to prevent further spread of the disease
To alert public health authorities to the presence of diphtheria cases and the possibility of additional cases developing in the area, a particular concern given the large number of susceptible adults

Legal Reporting Requirements

Health care providers and Health care facilities: immediately notifiable to local health jurisdiction.
Laboratories: immediately notifiable to local health jurisdiction; submission required – isolate within 2 business days; submission on request – specimen associated with positive result, within 2 business days.
Local health jurisdictions: immediately notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE) at 877-539-4344 or 206-415-5500.