Diphtheria

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.

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

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

The diphtheria bacterium can enter the body through the nose and mouth. 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.

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 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

Among the 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.

We highly recommend giving all healthy children the DTaP vaccine.