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Division of Public Health Services Disease Handbook for Childcare Providers Bureau of Infectious Disease Control REVISED –January 2018 DIPHTHERIA Diphtheria is a potentially serious bacterial infection of the nose and throat. Who gets this disease? Diphtheria occurs primarily among unimmunized or inadequately immunized people. How is it spread? The bacteria are spread by direct contact with discharge from the nose, throat, skin, eyes, or from sores of infected persons. Articles or food contaminated with discharge can also spread infection. What are the symptoms? Diphtheria causes a sore throat and swollen tonsils, with a grayish cov ering and swollen glands in the neck. It can lead to severe throat swelling that can block breathing. The bacteria also produce a toxin (a type of poisonous substance) that can cause severe and permanent damage to the nervous system and heart. What is the Treatment? Diphtheria is treated primarily with an antitoxin, along with antibiotics. Antibiotics are also given to the carriers of the diphtheria (e.g., people who test positive for diphtheria but who are not sick). Individuals who have been in cont act with an infected person and are not adequately vaccinated should receive a booster. How can the spread of this disease be prevented? The combination vaccine Diphtheria, Tetanus and acellular Pertussis (DTap), is required for both childcare and school attendance. The Advisory Committee on Immunization Practices (ACIP) recommends immunizing children against diphtheria, along with pertussis and tetanus, beginning as early as six weeks of age. The five dose series should be completed at 2 months, 4 months, 6 months, and 15- 18 months, and 4- 6 years of age. Patients and carriers of diphtheria should receive appropriate treatment and not return to childcare until two (2) cultures from both the nose and throat (and from skin sores in cutaneous diptheria), a re negative for the bacteria. These cultures should be taken at least 24 hours apart and no sooner than 24 hours after finishing antibiotic treatment. Where culture is impractical, isolation may be ended after 14 days of appropriate treatment. Who should be excluded? Children and staff should be excluded until bacteriological examination proves them not to be carriers. Reportable? Yes, Diphtheria is reportable by New Hampshire law to the Division of Public Health Services, Bureau of Infectious Disease C ontrol at (603) 271-4496. |