Diphtheria (cont.)

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What are the complications of diphtheria?

The potential complications of diphtheria may include the following:

  • Cardiac (inflammation of the heart, heart valve infection, heart rhythm disturbances, and congestive heart failure)

  • Neurologic (muscle paralysis, muscle weakness, and vision problems)

  • Infectious (lung infection, blood infection, and bone infection)

  • Death

For diphtheria, the overall fatality rate is 5%-10%, although it may be higher (up to 20%) in patients less than 5 years of age and older than 40 years of age. Airway obstruction and cardiac complications are the most common causes of death.

How is diphtheria prevented?

The prevention of diphtheria is best achieved through universal immunization with diphtheria toxoid-containing vaccines. Immunization for infants and children consists of five DTaP vaccinations generally given at ages 2, 4, and 6 months, with the fourth dose being administered between 15-18 months, and the fifth dose at ages 4-6 years. At age 11-12 years, children should receive a single Tdap (tetanus, diphtheria, and pertussis) vaccination if they have completed the recommended childhood vaccination schedule. Because immunity wanes over time, subsequent booster immunization is required every 10 years thereafter to maintain protective antibody levels. As noted previously, widespread vaccination against diphtheria has resulted in a significant decrease in the incidence of this disease worldwide, and in the United States documented cases of the disease have become exceedingly rare.

Travelers to areas where diphtheria is endemic should review and update their vaccinations as necessary.


United States. Centers for Disease Control and Prevention. "Diphtheria." May 13, 2013. <http://www.cdc.gov/diphtheria/index.html>.

Medically Reviewed by a Doctor on 11/26/2013

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