Diphtheria

Question 1

What is diphtheria?

Answer 1

A bacterial infection caused by Corynebacterium diphtheriae, transmitted from peron-to-person through close physical and respiratory contact.

Question 2

What percentage of UK adults over 30 years are susceptible to diphtheria?

Answer 2

around 50%

Question 3

What bacterium causes diphtheria?

Answer 3

Corynebacterium diphtheriae

Question 4

Which parts of the body dose diphtheria typically affect?

Answer 4

It typically affects the upper-respiratory tract (respiratory diphtheria) or skin (cutaneous diphtheria)

Question 5

Which countries have reported cases of diphtheria?

Answer 5

North America, South America, Russia, South and South East Asia, Australia

Question 6

How is diphtheria transmitted?

Answer 6

person-to-person through oral or respiratory droplets, or via contact with contaminated objects

Question 7

What are the symptoms of diphtheria?

Answer 7

Common presenting: mild fever, sore throat, difficulty swallowing, malaise, loss of appetite and hoarseness (if the larynx is involved)

Later symptoms: appearance of a pseudomembrane and oedema of the soft tissues (“bull neck”)

Question 8

Which bodily systems can diphtheria toxin affect?

Answer 8

Myocardium, nervous system and kidneys leading to paralysis and cardiac failure

Question 9

Where dose cutaneous diphtheria usually appear?

Answer 9

exposed limbs, particularly the legs

Question 10

What is cutaneous diphtheria characterised by?

Answer 10

ulcers covered with a grey membrane

Question 11

What is the incubation period for diptheria?

Answer 11

2-5 days

Question 12

What advice is given to travellers relating to diphtheria?

Answer 12

All eligible children should be vaccinated against diphtheria as part of the routine childhood vaccination schedule.

Adults should consider booster vaccine when travelling to destinations where diphtheria is endemic.

Question 13

Does diphtheria vaccine come as a single monovalent vaccine?

Answer 13

No, the diphtheria vaccine is only given as part of combined products

Question 14

How many strengths of diphtheria vaccine are produced?

Answer 14

Two strengths

1. high dose diphtheria toxoid (D) contain not less than 30IU
2. lower dose diphtheria toxoid (d) contain approximately 2IU

Question 15

What are the three combination products diphtheria is given in?

Answer 15

1. (DTaP/IPV/Hib) diphtheria/tetanus/acellular pertussis/inactivated polio vaccine/Haemophilus influenzae type b
2. (dTaP/IPV or DTaP/IPV)
   diphtheria/tetanus/ acellular pertussis/inactivated polio vaccine
3. (Td/IPV)
   tetanus/diphtheria/inactivated polio vaccine

Question 16

Which diphtheria vaccine is used for travellers going into endemic regions?

Answer 16

Revaxis (Td/IPV) where final dose of relevant antigen was recieved more than 10 years ago