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Respiratory Diphtheria in a Pennsylvania resident recently returned from Haiti : report underscores importance of vaccination to prevent diphtheria
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10/24/2003
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Series: HAN ; 161
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Description:Monday, October 24, 2003, 14:20 EDT (02:20 PM EDT
CDCHAN-00161-03-10-24-UPD-N
On 10/18/03, the Pennsylvania Department of Health and CDC were notified of a case of respiratory diphtheria in a 63-year-old male. This Pennsylvania resident had reportedly never been vaccinated against diphtheria. From October 3-10, this man and seven other men from New York, Pennsylvania, and West Virginia had worked in a rural village in Haiti. On return to Pennsylvania, the man was admitted to a hospital because of his severe sore throat and respiratory distress. Respiratory diphtheria was suspected when, during a tracheostomy procedure, a pseudo membrane was seen throughout his upper airways consistent with respiratory diphtheria. Several days later, a sample of the pseudo membrane was PC R positive for Corynebacterium diphtheriae tox genes. Based on his history of travel to Haiti where diphtheria is endemic, his clinical symptoms, and the positive PC R results, this patient has a confirmed case of respiratory diphtheria.
Primary diphtheria immunization with diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) is recommended for all persons aged 6 weeks to 6 years of age. The five DTaP doses are administered at ages 2, 4, and 6 months, at 15-18 months and at 4-6 years. Adolescents and adults should receive the adult formulation of tetanus and diphtheria toxoids (Td) every 10 years.
Health care providers should ensure that travelers to all countries with endemic diphtheria are up-to-date with diphtheria and other vaccinations according to the ACIP guidelines. For additional information on diphtheria, please see the CDC website at: http://www.cdc.gov/nip/publications/surv-manual/default.htm For additional health information for international travel, please see the CDC website at http://www.cdc.gov/travel/yb/index.htm.
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