Diphtheria

[Amatullah0]

Can anyone offer some help in finding answers to these questions please?

-Should I be concerned about Diphtheria?
-What is the prevalence? In the US and in other countries. Is it endemic anywhere?
-Are there usually lasting damages, such as neurological impairment, paralysis?/Can it be left untreated?
-Is the vaccine(dt/td) "safe"? I can't find info on these two specific vaxes. We will not be doing DTaP, but we are considering dt/td, if we find it necessary.
-How does one contract Diphtheria?

I've read about the shick test, but only on wikipedia they say its no longer done because the vaccine is so safe... but, is that test still done?/is there even a point in doing it?

I am so scared about this disease, which makes me realize that I probably shouldn't be, and there has got to be something that I am missing.

Oh, also, share why you do/don't vax for this, and what arguments a ped might make for this vax.

[lillacfaerie]

Diphteria kills about 2,000 children in Africa every year and 3,000 in South East Asia. It's largely eradicated in the US. When it was still an issue here it killed abour 10 percent of its victims. I've only heard of one case recently, and I believe that baby died. So...the chance of your child getting the disease is slim, but if contracted it's quite serious.

[Sileree]

Should I be concerned about diphtheria?

Do you live in the U.S.? Then no.

What is the prevalence?

It's really, really rare in the U.S. There haven't been any cases since 2003.

See: http://www.cdc.gov/vaccines/Pubs/pin...ses&deaths.pdf

Is it endemic anywhere?

Endemic countries are listed here: http://wwwnc.cdc.gov/travel/yellowbo...iphtheria.aspx

Are there usually lasting damages, such as neurological impairment, paralysis?

There can be, yes. The above link discusses this.

How does one contract diphtheria?

It's not a contagious disease unless you travel to an endemic country and have sexual and/or close face-to-face contact with locals.

http://acta.uta.fi/english/teos.php?id=8914

"Respiratory tract diphtheria is not especially contagious."

http://www.ncbi.nlm.nih.gov/pubmed/10326290

"Diphtheria seems, however, not to be a highly contagious disease in modern Western society. Since the epidemic started in Russia (in 1990), over 6 million trips have been made from Finland to St. Petersburg and its surroundings. Among the visitors, only 10 cases of diphtheria have occurred. Three of them have had severe infection, all were middle-aged men with sexual contacts with local people. None of the 10 patients transmitted the infection further in."

I am so scared about this disease, which makes me realize that I probably shouldn't be, and there has got to be something that I am missing.

It's so rare some have said your kid is more likely to be bitten by a cobra than get diphtheria. I don't worry about it at all personally.

... what arguments a ped might make for this vax.

A ped might argue that diphtheria is rare because of herd immunity. This isn't true, it's a disease of poverty, owercrowding and a lack of sanitation.

The vaccine is designed to induce individual immunity to the toxins produced by the infected bacteria, not prevent carriage or transmission of the bacteria itself.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1349708/

"However, immunization with diphtheria toxoid is protective only against the phage-mediated toxin, and not against infection by the C. diphtheriae organism. Thus immunized persons have less severe disease when infected, but may remain important as asymptomatic carriers in the transmission of disease. Outbreaks in communities with up to 94 percent immunization levels have been reported. Therefore, some authors have challenged whether herd immunity is applicable to diphtheria."

[Deborah]

insidevaccines has a good article on diphtheria and the inflated numbers which are offered up by the CDC.

On what basis did this “expert” panel ignore the major society changes and public health changes which were responsible for a precipitous decline, or the antibiotic development which occurred after the vaccine was first used? On page 802 is a statement admitting that they ignored these key points:
...consensus from an expert panel that the disease burden without vaccination would be equal to that of the prevaccination era before the introduction of mass immunizations. In developed countries, however, the incidence of many infectious diseases, including diphtheria, tetanus, and pertussis, were declining before the introduction of universal immunization

[Amatullah0]

Originally Posted by Sileree

Do you live in the U.S.? Then no.



It's really, really rare in the U.S. There haven't been any cases since 2003.

See: http://www.cdc.gov/vaccines/Pubs/pin...ses&deaths.pdf



Endemic countries are listed here: http://wwwnc.cdc.gov/travel/yellowbo...iphtheria.aspx



There can be, yes. The above link discusses this.



It's not a contagious disease unless you travel to an endemic country and have sexual and/or close face-to-face contact with locals.

http://acta.uta.fi/english/teos.php?id=8914

"Respiratory tract diphtheria is not especially contagious."

http://www.ncbi.nlm.nih.gov/pubmed/10326290

"Diphtheria seems, however, not to be a highly contagious disease in modern Western society. Since the epidemic started in Russia (in 1990), over 6 million trips have been made from Finland to St. Petersburg and its surroundings. Among the visitors, only 10 cases of diphtheria have occurred. Three of them have had severe infection, all were middle-aged men with sexual contacts with local people. None of the 10 patients transmitted the infection further in."



It's so rare some have said your kid is more likely to be bitten by a cobra than get diphtheria. I don't worry about it at all personally.



A ped might argue that diphtheria is rare because of herd immunity. This isn't true, it's a disease of poverty, owercrowding and a lack of sanitation.

The vaccine is designed to induce individual immunity to the toxins produced by the infected bacteria, not prevent carriage or transmission of the bacteria itself.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1349708/

"However, immunization with diphtheria toxoid is protective only against the phage-mediated toxin, and not against infection by the C. diphtheriae organism. Thus immunized persons have less severe disease when infected, but may remain important as asymptomatic carriers in the transmission of disease. Outbreaks in communities with up to 94 percent immunization levels have been reported. Therefore, some authors have challenged whether herd immunity is applicable to diphtheria."

Awesome! Thanks for all of that info!