Diphtheria is a highly contagious infection. It can be life-threatening. It is caused by specific bacteria. The germ produces a toxin that can spread from the site of infection to other tissues in the body. Diphtheria usually affects the throat and nose. In serious cases, it may affect the nervous system and heart.
Diphtheria spreads easily from person to person by coughing or sneezing. People nearby breathe in the infected droplets. In rare cases, they come into direct contact with elements from an infected person’s mouth, nose, throat, or skin.
Because of a widespread immunization program, diphtheria is now rare in the United States.
The diphtheria vaccine is an inactivated toxin called a toxoid. There are different types of the vaccines to prevent diphtheria, including:
The vaccine is injected into the muscle.
The DTaP vaccine is generally required before starting school. The regular immunization schedule is to give the vaccine at:
Tdap is routinely recommended for children aged 11-12 years who have completed the DTaP series. Tdap can also be given to:
Td is given as a booster shot every 10 years.
Talk to a doctor if you or your child has not been fully vaccinated against tetanus.
As with any vaccine, there is a small risk of severe reaction, such as a severe allergic reaction. Most people get the vaccine without any problems. The most common reactions are mild.
Mild reactions may include:
More serious reactions include seizure, nonstop crying, fever over 105 degrees Fahrenheit (40.6 degrees Celsius), allergic reaction.
Very rare reactions may include long-term seizures, brain damage, and coma.
Mild reactions may include:
More serious reactions include fever over 102 degrees Fahrenheit (38.9 degrees Celsius), extensive swelling, severe pain, bleeding, and redness in the arm where the shot was given.
Mild reactions may include:
More serious reactions include fever over 102°F (38.9°C), extensive swelling, severe pain, bleeding, and redness in the arm where the shot was given.
Acetaminophen is sometimes given to help prevent pain and fever that may occur after getting a vaccine. In infants, the medication may make the vaccine weak. Talk with your doctor about the risks and benefits of taking acetaminophen. For children who have had a seizure in the past, controlling any fever may be important.
You should not get the vaccine if you:
Talk to your doctor if the person getting the vaccine has any nervous system problems or has had Guillain-Barre syndrome. Also talk to your doctor if your child has previously had a very high fever or nonstop crying after a previous dose of the vaccine.
Prevention depends on getting the vaccine and responding quickly to outbreaks.
Suspected cases of diphtheria need to be reported right away to public health authorities.
In the event of a suspected or confirmed outbreak, close contacts are at risk. For close contacts, treatment includes:
WHERE CAN I GET MORE INFORMATION?
Healthy Children—American Academy of Pediatrics
Vaccines & Immunizations
Centers for Disease Control and Prevention
Diphtheria. Nemours Kids Health website. Available at: http://www.kidshealth.org/parent/infections/bacterial_viral/diphtheria.html. Updated September 2011. Accessed June 5, 2013.
Diphtheria antitoxin. Centers for Disease Control and Protection website. Available at: http://www.cdc.gov/diphtheria/dat.html. Updated May 13, 2013. Accessed June 5, 2013.
Diphtheria, tetanus, and pertussis VIS. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.html. Updated May 17, 2007. Accessed June 5, 2013.
Diphtheria (DTaP, Tdap, Td). Immunization Action Coalition website. Available at: http://www.vaccineinformation.org/diphtheria. Updated January 28, 2013. Accessed June 5, 2013.
Immunization schedules. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/index.html. Updated January 29, 2013. Accessed June 5, 2013.
Tdap vaccine: What you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/tdap.html. Updated May 9, 2013. Accessed June 5, 2013.
10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Prymula R, Siegrist C, et al. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: Two open-label, randomised controlled trials. Lancet. 2009;374(9698):1339.
11/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant aged <12 months—Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep. 2011;60:1424-1426.
Last reviewed December 2014 by David L. Horn, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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