Diphtheria

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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What is the prognosis of diphtheria?

The prognosis of diphtheria ranges from good to poor, depending upon how early in the infection the patient is treated, and how the patient responds to treatment. If the patient develops sepsis or bacteremia, or if there's cardiac involvement, the prognosis is usually poor. The mortality (death) rate is highest in patients less than 5 years old and in patients that are older than 40. The average rate of death from is about 5%-10%.

Is it possible to prevent diphtheria? Is there a diphtheria vaccine?

It is possible to prevent diphtheria; the most effective way is to vaccinate people (infants, see below) early in their lives and to prevent infected individuals from coming in contact with uninfected people. In addition, individuals who are carriers of the bacteria can be treated with antibiotics to eliminate the bacteria and thus reduce the chance of carriers transmitting bacteria to others.

There are vaccines available to protect individuals from diphtheria and all formulations contain toxoid concentrations that stimulate antibody production against diphtheria toxin (D or d). These toxoid vaccinations also may contain acellular pertussis (aP or ap) and tetanus (T) vaccine. They are as follows: DTaP, Tdap, DT, and Td. DTaP is the childhood vaccine while Tdap is the adult vaccine. Perhaps the most important vaccine is DTaP, given at 2 months, 4 months, 6 months, 15-18 months, and 4-6 years of age.

DT does not contain pertussis and is given to children who have reacted to pertussis vaccine; Td is a vaccine for adolescents and adults given every 10 years as a booster for tetanus. Tdap has several formulations; the CDC in 2012 recommended that Tdap formulations be used as a booster to cover pertussis instead of just the Td formulation against tetanus and diphtheria only.

The side effects of these vaccines are usually mild such as pain or soreness at the injection site and/or a mild fever. These effects usually go away within a day. However, some patients do develop more severe symptoms; although this is infrequent, patients that do so should be aware of the reaction and inform any medical caregiver that they may have an allergy (for example, an allergy to tetanus or pertussis vaccine).

Medically reviewed by Robert Cox, MD; American Board of Internal Medicine with subspecialty in Infectious Disease

REFERENCES:

Lo, Bruce M. "Diphtheria." Medscape.com. Dec. 11, 2013. <http://emedicine.medscape.com/article/782051-overview>.

United States. Centers for Disease Control and Prevention. "Diphtheria." May 13, 2013. <http://www.cdc.gov/diphtheria/>.

Medically Reviewed by a Doctor on 3/22/2016

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