Fact sheets
The Department of Health, Western Australia, does not produce fact sheets on this topic.
Public Health action
Notifiable disease data and reports
Additional sources of information
Exclusion
Cases: exclude, respiratory precautions for pharyngeal diphtheria, contact precautions for cutaneous diphtheria.
Contacts: exclude those who handle food or work with school children/child care until proven not to be carriers. Evidence required – adequate antibiotic prophylaxis (see antibiotic guidelines) and two negative swabs, with the first swab greater than 24 hours after finishing antibiotics and the next 48 hours later.
Case definition
Both confirmed cases and probable cases should be notified.
Confirmed case
A confirmed case requires laboratory definitive evidence only.
Laboratory definitive evidence
Isolation of toxigenic Corynebacterium diphtheriae or toxigenic C. ulcerans.
Probable case
A probable case requires:
1. Laboratory suggestive evidence
AND clinical evidence
OR
2. Clinical evidence AND epidemiological evidence.
Laboratory suggestive evidence
Isolation of Corynebacterium diphtheriae or C. ulcerans (toxin production unknown).
Clinical evidence
At least one of the following:
1. Pharyngitis and/or laryngitis (with or without a membrane)
OR
2. Toxic (cardiac or neurological) symptoms.
Epidemiological evidence
An epidemiological link is established when there is:
1. Contact between two people involving a plausible mode of transmission at a time when:
a) one of them is likely to be infectious (usually 2 weeks or less and seldom more than 4 weeks after onset of symptoms)
AND
b) the other has an illness which starts within approximately 2-5 days after this contact
AND
2. At least one case in the chain of epidemiologically linked cases (which may involve many cases) is laboratory confirmed.
