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: immediately notifiable to local health jurisdiction.
  • Health care facilities: immediately notifiable to local health jurisdiction.
  • Laboratories: Corynebacterium diphtheriae immediately notifiable to local health jurisdiction, specimen submission required - culture (2 business days).
  • Local health jurisdictions: immediately notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE).