Contents

5 Diphtheria

Key information

Mode of transmission Contact with respiratory droplets or infected skin of a case or carrier or, more rarely, contaminated articles.
Incubation period Usually 2–5 days, occasionally longer.
Period of communicability Variable; usually 2 weeks or less, seldom more than
4 weeks. Carriers may shed for longer. Effective antimicrobial therapy promptly terminates shedding.
Funded vaccines DTaP-IPV-HepB/Hib (Infanrix-hexa).

DTaP-IPV (Infanrix-IPV).

Tdap (Boostrix).

Td (ADT Booster).
Funded vaccine indications and schedule At age 6 weeks, 3 months and 5 months: DTaP-IPV-HepB/Hib.

At age 4 years: DTaP-IPV.

At age 11 years: Tdap.

At ages 45 and 65 years: Td (administration not funded).

During pregnancy (from 28 to 38 weeks’ gestation): Tdap.

For (re-)vaccination of eligible patients. 
Dose interval between Td and Tdap No minimum interval is required between Td and Tdap, unless Tdap is being given as part of a primary immunisation course.
Vaccine efficacy/effectiveness 87–98 percent protection has been demonstrated using population-based analysis. Immunised cases have been shown to have less severe disease.
Herd immunity ≥70 percent of the childhood population must be immune to diphtheria to prevent major community outbreaks.