Diphtheria in Children
What is diphtheria?
Diphtheria, a childhood disease that was common in the 1930s, is an acute bacterial
disease that can infect the body in 2 areas:
The throat, nose, and tonsils (respiratory diphtheria)
The skin (skin or cutaneous diphtheria)
A vaccine against diphtheria has made it very rare today in the U.S. and other developed
How is diphtheria transmitted?
The diphtheria bacterium can enter the body through the nose and mouth. However, it
can also enter through a break in the skin. It is transmitted from person-to-person
in close contact by aerosol route. This means breathing in respiratory secretions
or droplets that contain diphtheria bacteria from an infected person coughing, sneezing,
or laughing. After being exposed to the bacteria, it usually takes 2 to 4 days for
symptoms to develop.
What are the symptoms of diphtheria?
The following are the most common symptoms of diphtheria. However, each child may
experience symptoms differently. Symptoms may include:
Respiratory diphtheria. When a child is infected with diphtheria, the bacterium usually multiplies in the
throat. This leads to respiratory diphtheria. A membrane may form over the throat
and tonsils, causing a sore throat. Other common symptoms of respiratory diphtheria
Low grade fever
Stridor (a shrill breathing sound heard during inspiration, or breathing in)
Enlarged lymph glands of the neck
Increased heart rate
Swelling of the palate (the roof of the mouth)
Children may die from asphyxiation when the membrane obstructs breathing. Other complications
of respiratory diphtheria are caused by the diphtheria toxin released in the blood.
This leads to kidney or heart failure.
Skin (cutaneous) diphtheria. With this type of diphtheria, the symptoms are usually milder. They may include yellow
spots or sores (similar to impetigo) on the skin.
The symptoms of diphtheria may resemble other problems or medical conditions. Always
talk with your child's healthcare provider for a diagnosis.
How is diphtheria diagnosed?
A healthcare provider can usually diagnose the illness based on clinical exam. A swab
culture of the mouth or affected mucous membrane may also be used to confirm the diagnosis.
What is the treatment for diphtheria?
Your child's healthcare provider will figure out the best treatment for your child
How old your child is
His or her overall health and past health
How sick he or she is
How well your child can handle specific medicines, procedures, or therapies
How long the condition is expected to last
Your opinion or preference
Antibiotics are usually effective in treating respiratory diphtheria early on before
it releases toxins in the blood. An antitoxin can be given in combination with the
antibiotics, if diphtheria is suspected. Sometimes a tracheostomy (a breathing tube
surgically inserted in the windpipe) is necessary if the child has severe breathing
How is diphtheria prevented?
In their first year of life, children in the U.S. are routinely given a triple vaccine
(DTaP) that includes diphtheria. Because diphtheria still prevails in underdeveloped
countries, the vaccine remains necessary in case of exposure to a carrier visiting
from another country.
What are the facts about immunization against diphtheria, tetanus, and pertussis?
Diphtheria, tetanus, and pertussis vaccines prevent these diseases. Most children
who receive all of their shots will be protected during childhood. A combination vaccine
is given to babies and children and provides protection against all 3 diseases. There
are several types of the vaccine; however, the newer form is the DTaP:
Protects against diphtheria, tetanus, and pertussis.
Is a newer form of the vaccine and is less likely to cause reactions than earlier
When are DTaP vaccines given?
The CDC recommends that children need 5 DTaP shots. The first 3 shots are given at
2, 4, and 6 months of age. Between 15 and 18 months of age, the fourth shot is given,
and a fifth shot when a child enters school at 4 to 6 years of age. At regular checkups
for 11- or 12-year-olds, a preteen should get a booster dose of another form of this
vaccine called Tdap. Always talk with your child's healthcare provider for advice.