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Diphtheria in Washington
State
Diphtheria is rare in the United States with only 0–5 cases
reported annually. The last major outbreak in the United
States occurred in Seattle, Washington. There were three
outbreaks of cutaneous diphtheria in Seattle from 1972
through 1982. The first outbreak was due to a toxigenic
strain while the later outbreaks were nontoxigenic strains.
The last case of toxigenic diphtheria reported in
Washington occurred in 1979. Cases now occur only rarely
and are travel-associated since diphtheria is no longer
endemic in Washington.
Between 1980 and
2005, 55 cases of diphtheria were reported in the United
States. The majority of cases (77%) were in persons 15
years of age and older, and 4 of 5 fatal cases were in
unvaccinated children. Although few cases of respiratory
diphtheria have been reported in recent years, enhanced
surveillance has shown ongoing circulation of toxigenic
C. diphtheriae in a Northern Plains Indian community,
where the disease was previously endemic, and in some
communities in Canada. Cutaneous diphtheria due to
nontoxigenic strains is still known to occur, particularly
among homeless persons.
Purpose of Reporting and
Surveillance
- To assist in the diagnosis
of cases.
- To assure early and
appropriate treatment with diphtheria antitoxin and
antibiotics.
- To identify and evaluate
contacts and recommend appropriate antibiotic prophylaxis
and/or immunization to prevent further spread of the
disease.
- To alert public health
authorities to the presence of diphtheria cases and the
possibility of additional cases developing in the area, a
particular concern given the large number of susceptible
adults.
Legal Reporting Requirements
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Health care
providers: immediately notifiable to local health
jurisdiction.
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Hospitals:
immediately notifiable to local health jurisdiction.
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Laboratories:
notifiable to local health jurisdiction within 2 work
days, specimen submission required.
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Local health
jurisdiction: notifiable to the Washington State
Department of Health (DOH) Communicable Disease
Epidemiology Section (CDES) within 7 days of case
investigation completion or summary information required
within 21 days
Last
update
Dec. 2008 |
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