What factors contribute to susceptibility to diphtheria?

Updated: Jan 18, 2019
  • Author: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Overcrowding, poor health, substandard living conditions, incomplete immunization, and immunocompromised states facilitate susceptibility to diphtheria and are risk factors associated with transmission of this disease. [7] Human carriers are the main reservoir of infection; however, case reports have linked the disease to livestock. [5, 4] Infected patients and asymptomatic carriers can transmit C diphtheria via respiratory droplets, nasopharyngeal secretions, and rarely fomites. [1, 2] In the case of cutaneous disease, contact with wound exudates may result in the transmission of the disease to the skin as well the respiratory tract. [4]

Immunity from exposure or vaccination wanes over time. Inadequate boosting of previously vaccinated individuals may result in increased risk of acquiring the disease from a carrier, even if adequately immunized previously. Additionally, since the advent of widespread vaccination, cases of nontoxigenic strains causing invasive disease have increased. [8]

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