A second case of diphtheria of the throat has been confirmed in Northern New South Wales, as that of a 6-year-old child who was initially identified as a close family contact of the first announced case (a 2-year-old, 2 July 2022).
The child is being cared for at a Northern NSW Local Health District hospital where they were first admitted as a precaution as a close contact. The child was not vaccinated against diphtheria, which is available from six weeks of age as part of the Australian Childhood Immunisation program along with tetanus and pertussis (whooping cough).
Diphtheria is contagious, vaccine-preventable infection, and is usually spread through close contact with respiratory droplets from an infected person. It can also rarely be spread from close contact with discharges from the upper respiratory tract or skin lesions,. No other cases of throat diphtheria have been reported in NSW since the 1990s, however, less serious cases have been reported which are mostly on the skin.
Consider diphtheria in patients presenting with sore throat who are not fully immunised. Look for the formation of a greyish-white membrane over the throat and tonsils. Enlarged anterior cervical lymph nodes and surrounding oedema can also occur. Laryngeal infection can be life-threatening, so GPs are advised to refer suspected cases to the emergency department for testing and ongoing management.
The current risk to community is low, however diphtheria is a serious disease that can be fatal and residents are encouraged to ensure immunisations are kept up to date.
The diphtheria vaccination is included in the National Immunisation program Schedule for children aged from 6 weeks. Boosters are funded for adolescents aged 12-13 years and for pregnant women in a pertussis containing vaccination. A booster is also recommended for adults aged 50 years and over if their last dose was more than 10 years ago. Catch up immunisation is recommended for adolescents and adults who have not received a primary course, or for infants and children who have missed a dose of diphtheria containing vaccination.
For additional information see:
NSW Health – Diphtheria fact sheet – Fact sheets
Australian Government Department of Health – Australian Immunisation Handbook – Diptheria
Sharing Knowledge about Immunisation – Talking about Immunisation
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