infectious diseases
Diphtheria
Prevention of Diphtheria
Prevention consists of Infection control measures (respiratory droplet isolation until 2 cultures at least 24 hours apart are negative) Vaccination (primary and postexposure) Antibiotics See Diphtheria-Tetanus-Pertussis Vaccine for more information, including The vaccine for diphtheria contains diphtheria toxoid; it is available only in combination with other vaccines. Everyone should be vaccinated at prescribed intervals using the following: Children < 7 years of age: The Diphtheria-Tetanus-Pertussis Vaccine (DTaP) vaccine is part of Adolescents and adults: The Dose and Administration (Tdap) vaccine is given at age 11 or 12 and to people ≥ 13 years of age who have never received Tdap (regardless of the interval since the last tetanus-diphtheria [Td] vaccine) or whose vaccine status is unknown. A After exposure, diphtheria immunization should be updated in all contacts (including hospital personnel) who have not completed a primary series or who have gone>5 years since their last booster dose. The vaccine should also be given if immunization status is unknown. An age-appropriate diphtheria toxoid-containing vaccine is used. All close contacts should be examined; surveillance for evidence of disease is maintained for 7 days. Nasopharyngeal and throat cultures forC. diphtheriaeshould be done regardless of immunization status because the vaccine protects only against the effects of diphtheria toxin; it does not prevent infection withC. diphtheriae. Asymptomatic contacts should be treated witherythromycin500 mg (10 to 15 mg/kg for children) orally every 6 hours for 7 days or, if adherence is uncertain, a single dose ofpenicillin G benzathine(600,000 units IM for patients<30 kg and 1.2 million units IM for those>30 kg). If cultures are positive, an additional 10-day course oferythromycinshould be given; carriers should not be given antitoxin. After 3 days of treatment, carriers can safely resume work while continuing to take antibiotics. Cultures should be repeated; 24 hours after the completion of antimicrobial therapy, 2 consecutive culture sets of the nose and throat should be collected 24 hours apart. If results are positive, another course of antibiotics is given and cultures are done again. 