Diphtheria

Diphtheria-containing vaccines are on the Australian Immunisation Schedule and recommended for:

  • infants, children and adolescents as part of their routine immunisations
  • boosters vaccination for adults in special risk groups such as
    • laboratory workers
    • travellers to countries where health services are difficult to access
  • vaccination of people who have missed doses of diphtheria-containing vaccine

In the 1900s, diphtheria caused more deaths in Australia than any other infectious disease and was a common cause of death in children, but has now almost disappeared in Australia due to immunisation. However, it remains endemic in many developing countries. These days most Australian cases are imported from overseas. In 2018 there was a case in the Northern Rivers, and the same year an unimmunised person who had never been overseas died from diphtheria in Queensland.

The disease

Diphtheria is an illness caused by the bacterium Corynebacterium diphtheriae. Infection can produce a thick membrane in the pharynx, causing severe respiratory obstruction. The bacteria also produce a toxin that can cause life-threatening heart failure and paralysis.

The vaccine

Diphtheria-containing vaccines are only available in Australia as combination vaccines that include other antigens such as pertussis and tetanus.

Diphtheria-containing vaccines are recommended for children at 2, 4,  6 and 18 months, and 4 years of age, and adolescents at 11–13 years of age.

A diphtheria-containing vaccine booster is recommended for adults at 50 years of age.

Vaccination is recommended every 10 years for travellers to countries where health services are difficult to access. Travellers to some areas where there is a higher risk of acquiring diphtheria are recommended to be vaccinated every 5 years.

Laboratory workers who may be exposed to toxigenic Corynebacterium diphtheriae in their jobs are recommended to have a serology test for diphtheria antibodies every 10 years. They should receive a booster dose of either (reduced antigen content diphtheria-tetanus-acellular pertussis) or (diphtheria-tetanus) if the diphtheria antitoxin level is <0.1  per mL.

Adolescents and adults who have never had a diphtheria-containing vaccine are recommended to receive 3 doses of diphtheria-containing vaccine with at least 4 weeks between doses, and booster doses at 10 years and 20 years after the primary course.

 

(Text adapted from the Australian Immunisation Handbook)

For more information about diphtheria and the vaccine available please see here.

Page reviewed November 2018.
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