Respiratory diphtheria: Recommendations for case management and investigation of close contacts

* Close contacts include household members and other persons with a history of direct contact with a case-patient (eg, caretakers, relatives, or friends who regularly visit the home) as well as medical staff exposed to oral or respiratory secretions of a case-patient.

¶ Strict isolation should be maintained until two cultures are negative at least 24 hours apart after completion of antimicrobial therapy.

Δ Equine diphtheria antitoxin can be obtained from either the Centers for Disease Control and Prevention (1-404-639-2889), or Connaught Laboratories, Swiftwater, PA. Before administration, patients should be tested for sensitivity to horse serum and, if necessary, desensitized. The recommended dosage and route of administration depend on the extent and duration of disease.