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  • Overview

    A common childhood disease in the 1930s, diphtheria is a bacterial disease that can infect the throat (respiratory diphtheria) or the skin (skin or cutaneous diphtheria). While it can be caught from a child who is infected, it's very rare in the United States, thanks to the diphtheria vaccine. The Division of Infectious Diseases at Boston Children's Hospital provides comprehensive inpatient and outpatient care for children with diphtheria, including consultations for unusual infections.

    • There are two kinds: respiratory diphtheria and cutaneous (skin) diphtheria.
    • It can enter your body from the mouth or the nose.
    • The vaccine is given to most children in the first year.
    • Treatment may include antibiotics and antitoxins.

    How Boston Children's Hospital approaches diphtheria, tetanus and pertussis

    Children's highly recommends giving all healthy children the DTaP vaccine.

  • In-Depth

    What is diphtheria?

    A common childhood disease in the 1930s, diphtheria is an acute bacterial disease that can infect the throat (respiratory diphtheria) or the skin (skin or cutaneous diphtheria). It is rare today, thanks to the diphtheria vaccine.

    Types of diphtheria

    • Respiratory diphtheria
      • when diphtheria bacterium multiplies in the throat
      • a membrane may form over the throat and tonsils, causing a sore throat among other symptoms
      • asphyxiation may occur
      • may also release toxins into the blood, causing heart failure
    • Cutaneous diphtheria
      • a skin infection, also called skin diphtheria
      • symptoms are usually milder and may include yellow spots or sores on the skin

    What causes diphtheria?

    The diphtheria bacterium can enter the body through the nose and mouth. However, it can also enter through a break in the skin. It's transmitted from person-to-person by coughing or sneezing. After being exposed to the bacteria, it usually takes two to four days for symptoms to develop.

    Is diphtheria common?

    No, thanks to the diphtheria, tetanus, and pertussis vaccine (DTaP), diphtheria is very rare today in the United States and other developed nations.

    What are the symptoms of diphtheria?

    While symptoms vary from child to child, the most common include:

    • For respiratory diphtheria
      • sore throat
      • breathing difficulty
      • husky voice
      • stridor (a shrill breathing sound heard during inspiration, or breathing in)
      • enlarged lymph glands of the neck
      • increased heart rate
      • nasal drainage
      • swelling of the palate (the roof of the mouth)
    • For cutaneous diphtheria
      • yellow spots or sores on the skin

    Can you prevent diphtheria?

    The diphtheria, tetanus and pertussis vaccine routinely given during your child's first year prevents diphtheria. Because diphtheria still exists in underdeveloped countries, the vaccine remains necessary.

    There are several types of the vaccine:

    • DTaP vaccine
      • protects against diphtheria, tetanus and pertussis
      • a newer form of the vaccine and is less likely to cause reactions than earlier types given.
      • given at 2 months, 4 months, 6 months, 15 to 18 months, 4 to 6 years, and 11 to 12 years (and a booster every 10 years thereafter)
    • Tdap vaccine
      • protects against tetanus, diphtheria and pertussis
      • recommended for adolescents ages 11 to 18 years who have completed the recommended DTP/DTaP series

    Some children should not get the DTaP vaccines, or should get them later. These include children who:

    • previously had a moderate or serious reaction after getting vaccinated
    • previously had a seizure
    • have a parent or sibling who has had a seizure
    • have a brain problem that is becoming worse
    • currently have a moderate or severe illness
  • Tests

    How does a doctor know that it's diphtheria?

    A doctor can usually diagnose the illness based on an examination. A swab culture of the mouth or affected mucous membrane may also confirm the diagnosis.

  • Traditional treatments for diphtheria:

    • Antibiotics are usually effective in treating respiratory diphtheria before it releases toxins in the blood
    • An antitoxin can be given in combination with the antibiotics, if diphtheria is suspected
    • A tracheostomy (a breathing tube surgically inserted in the windpipe) may be necessary if your child has severe breathing difficulties.
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