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Diphtheria (Contacts: (PEP: vaccination (primary or booster) and Abx (Abx:…
Diphtheria
Contacts:
Highest risk: children <1 yr, esp if fewer than 3 doses of vaccine.
Defn: exposure to infectious case within 7 days : household/dormitory/intimate partner, HCWs exposed to NP secretions (intubation, mouth-to-mouth), child care in same room for >4 hrs, travel contacts (>8 hrs adjacent to case)
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Case Management
Case Ix: vaccination status, clinical course.
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Exclusion: from work, schools and children services until 2x -ve throat swabs, no sooner than 24 hr post abx completion
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Corynebacterium diphtheria, vaccine preventable.
Vaccination given 2,4,6,18 months and yr 7
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Clinical illness: bull-neck appearance, sore throat (grey membrane over the pharynx), lymphadenopathy. Can also have cutaneous diphtheria. Complications: pericarditis, myocarditis, peripheral neuritis, cardiac failure
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Infectious period: about 2 weeks, Abx terminates communicability
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