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Disease Name: Diphtheria


Quick Links

Please review the Idaho Reportable Disease Rules (IDAPA 16.02.10) for the most up-to-date information.

Diphtheria: http://www.cdc.gov/diphtheria/index.html


Overview / Case Definition

An infection caused by the bacterium Corynebacterium diphtheriae. Diphtheria causes a thick covering in the back of the throat. It can lead to difficulty breathing, heart failure, paralysis, and even death.

Membranous pharyngitis associated with a bloody nasal discharge should suggest diphtheria and local infections associated with a low-grade fever and gradual onset of manifestations over 1 to 2 days. Less commonly, diphtheria presents as a cutaneous, vaginal, conjunctival, or optic infection.


Restrictions

Daycare Facility

A person diagnosed with diphtheria must not work in or attend a daycare facility while the disease is in a communicable form.

Health Care Facility

a. A person with oropharyngeal toxigenic diphtheria in a health care facility must be managed under the “Guideline for Isolation Precautions in Hospitals.” The Department or Health District may withdraw this isolation requirement after two (2) cultures of the nose and two (2) cultures from the throat, taken at least twenty-four (24) hours apart and at least twenty-four (24) hours after the completion of antibiotic therapy, fail to show toxigenic Corynebacterium diphtheriae upon testing by a licensed laboratory.

b. A person with cutaneous toxigenic diphtheria must be placed under contact precautions. The Department or Health District may withdraw these precautions after two (2) cultures from the wound fail to show toxigenic Corynebacterium diphtheriae upon testing by a licensed laboratory.

Contacts

Contacts of a person with toxigenic diphtheria are restricted from working as food employees, working in health care facilities, or from attending or working in daycare facilities or schools until they are determined not to be carriers by means of a nasopharyngeal culture or culture of other site suspected to be infected. These restrictions may be withdrawn by the Department or Health District.


Reporting

Immediately, at the time of identification.

Reportable by Healthcare and Labs:

Reportable by Food Service Facility:

Suspect Reportable:

Reporting Timeframe: Immediately, at the time of identification.



Diagnosis / Testing

Swabs from the nose, throat or wounds may be tested for the bacteria.


Treatment

Antitoxin

Single dose of equine antitoxin should be administered on the basis of clinical diagnosis, even before culture results are available. To neutralize toxin from the organism as rapidly as possible, intravenous administration of the antitoxin is preferred.

If diphtheria is suspected and antitoxin is needed, immediately contact the local epidemiologist at (866) 710-9775, state epidemiologist at (208) 334-5939 or have the state epidemiologist paged from Idaho State Communications line at (800) 632-8000.


Additional Information

Diphtheria: http://www.cdc.gov/diphtheria/index.html


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