What factors predispose individuals to diphtheria infection?

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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Answer

The following factors may predispose to diphtheria infection:

  • Incomplete or absent immunization, which is especially important in the adult population, and as well the pediatric population in underdeveloped countries, may predispose to infection. In some cases, immunity does not prevent infection but lessens the severity of the disease. [10]

  • Antitoxin titers decrease over time and immunity wanes, thus older people who have not received booster vaccination are more susceptible to contract the disease from carriers. Studies suggest if titer level is greater than 0.1 UI/mL, then an individual is characterized as immune from infection.

  • Low herd immunity, possibly leading to increasing prevalence of diphtheria infections

  • Travel to endemic areas or regions with current epidemics

  • Immunocompromised states - Due to pharmacologic immune suppression, disease states including HIV, or relative compromise such as from diabetes or alcoholism

  • Low socioeconomic status

  • Large-scale population movements - Implicated in the spread of the epidemic in the Newly Independent States of the former Soviet Union [22]

  • Poor healthcare care system infrastructure

  • Overcrowding - Military barracks, homeless shelters, jails

  • Domestic animals such as cats may act as reservoir for human infection. [14]


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