Diphtheria in Children

What is diphtheria in children?

Diphtheria is an illness caused by bacteria. There are 2 types:

• Respiratory diphtheria. This type affects the throat, nose, and tonsils.
• Skin (cutaneous) diphtheria. This type affects the skin.

Diphtheria is a childhood disease that was common in the 1930s. A vaccine against diphtheria has made it very rare today in the U.S. and other developed countries.

What causes diphtheria in a child?

Diphtheria bacteria can enter the body through the nose and mouth. It can also enter through a break in the skin. It is spread by breathing in droplets that contain diphtheria bacteria from an infected person when he or she coughs, sneezes, or laughs.

What are the symptoms of diphtheria in a child?

Symptoms occur 2 to 4 days after contact with the bacteria. Symptoms can occur a bit differently in each child. The most common symptoms are below.

Common symptoms of respiratory diphtheria may include:

• Sore throat
• Trouble breathing
• Low fever
• Husky voice
• A shrill sound caused when breathing in (stridor)
• Enlarged lymph glands in the neck
• Increased heart rate
• Runny nose
• Swelling of the roof of the mouth (palate)

Symptoms of skin (cutaneous) diphtheria are usually milder and may include yellow spots or sores on the skin.

The symptoms of diphtheria can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is diphtheria diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. This may be enough to diagnose the illness. The healthcare provider may also swab the mouth for a culture to confirm the diagnosis.

How is diphtheria treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Antibiotic medicine is used to treat respiratory diphtheria as early as possible, before toxins are released in the blood. An antitoxin may be given along with the antibiotics, if needed. Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all medicines.

If your child has severe breathing problems, he or she may need a breathing machine (mechanical ventilator). A breathing tube is inserted in the front of the windpipe in a small surgery. This is called a tracheostomy. The tube is left in place as long as it’s needed, and removed as your child gets better.

What are possible complications of diphtheria in a child?

A child may die from loss of breathing (asphyxiation) if the disease blocks the throat. Other possible problems of respiratory diphtheria are kidney or heart failure. These can be caused by the diphtheria toxin released in the blood.

How can I help prevent diphtheria in my child?

In their first year of life, children in the U.S. are given a triple vaccine (DTaP) that includes diphtheria. This combination vaccine also protects against tetanus and pertussis. Because diphtheria is still common in underdeveloped countries, the vaccine is still needed in case of contact with a person who is carrying the bacteria.

Most children who get all of their shots will be protected during childhood. There are several types of the vaccine, but the newer form is the DTaP. The DTaP vaccine is less likely to cause reactions than earlier types given.

The CDC recommends that children need 5 DTaP shots at these ages:

• Shot #1 at 2 months of age
• Shot #2 at 4 months of age
• Shot #3 at 36 months of age
• Shot #4 between 15 months and 18 months of age
• Shot #5 when a child enters school at 4 to 6 years of age

A preteen (age 11 or 12) should get a booster dose of another form of this vaccine called Tdap at a checkup. Talk with your child's healthcare provider for advice.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

• Symptoms that don’t get better, or get worse
• New symptoms

Key points about diphtheria in children

• Diphtheria is an illness caused by bacteria. There are 2 types. Respiratory diphtheria affects the throat, nose, and tonsils. Skin (cutaneous) diphtheria affects the skin.
• Common symptoms of respiratory diphtheria may include sore throat, trouble breathing, and low fever.
• Symptoms of skin diphtheria may include yellow spots or sores on the skin.
• Antibiotic medicine is used to treat respiratory diphtheria as early as possible before toxins are released in the blood. An antitoxin may be given along with the antibiotics.
• If your child has severe breathing problems, he or she may need a breathing machine (mechanical ventilator).
• The CDC recommends that children are given 5 shots of a triple vaccine (DTaP) at specific ages.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.