Interventions for Diphtheria

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Age Cohort: Pregnancy and newborn

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Information and health education to women, families and community on Diphtheria including prevention measures Provide Information to women, families, and community on; Immunization Educate mothers on well baby clinics Good nutrition for the mother Community health workers education on Diphtheria	Timely attendance to ANC clinic Routine vaccination for women and girls of childbearing age with Tdap		Recognition of features of Diphtheria in pregnant women which include: sore throat, low fever and swollen glands in the neck, a thick coating in the throat or nose, hoarse voice Supportive management for pregnant women suspected to have Diphtheria Plenty of rest Proper nutrition for a pregnant woman with diphtheria Referral to a health facility of pregnant women with suspected diphtheria
Primary Care
Maternal education on diphtheria and prevention measures Maternal education on importance of immunization Creation of awareness on the importance of immunization Sensitization on proper hygiene practices Health workers education on diphtheria including its management in pregnant women	Vaccination with Tdap during routine wellness visits to women and girls of childbearing age Provide ANC services for women including health education on diptheria Provide Post-natal care services		Clinical examination and diagnosis of diphtheria in pregnant women Supportive management to pregnant mothers with diphtheria to/Relieve common symptoms Relieve fever with anti pyretics/analgesics such as paracetamol and ibuprofen. Provide nutritional support for the adults with diphtheria Monitoring and recognition for any features of worsening of diphtherias in pregnant mothers which including shortness of breath/breathing difficulties Immunization with diphtheria toxoid vaccine for pregnant mothers Fetal monitoring Emergency care with an aim of stabilizing the pregnant women with complications due to diphtheria before referral Referral of pregnant with complications due to diphtheria-eg shortness of breath to a hospital Referral to hospital for neonates with poor outcomes such as low birth weights, preterm babies
Referral Facility: General
Maternal education on diphtheria and prevention measures Maternal education on importance of immunization Creation of awareness on the importance of immunization Sensitization on proper hygiene practices Health workers education on diphtheria including its management in pregnant women	Vaccination with Tdap during routine wellness visits to women and girls of childbearing age ANC services Post-natal services		Clinical examination and diagnosis of diptheria in pregnant women Supportive management to pregnant mothers with diphtheria to/Relieve common symptoms Relieve fever with anti pyretics/analgesics such as paracetamol and ibuprofen Immunization with diphtheria toxoid vaccine for pregnant mothers Fetal monitoring Provide nutritional support for the adults with diphtheria Monitoring and Management of complications of diphtheria in pregnant women such as shortness of breath/breathing difficulties Management of neonates with low birth weights, preterm babies/as a result of diphtheria		Psycho social support to mothers who may have poor pregnancy outcomes due to diphtheria e.g low birth weight babies, preterm
Referral Facility: Specialist
workers education on diphtheria including its management in pregnant women Maternal education on diphtheria and prevention measures Maternal education on importance of immunization Creation of awareness on the importance of immunization Sensitization on proper hygiene practices	ANC services Post-natal services Vaccination with Tdap during routine wellness visits to women and girls of childbearing age		Provide nutritional support for the adults with diphtheria Clinical examination and diagnosis of diptheria in pregnant women Immunization with diphtheria toxoid vaccine for pregnant mothers Fetal monitoring Monitoring and Management of complications of diphtheria in pregnant women such as shortness of breath/breathing difficulties Management of neonates with low birth weights, preterm babies/as a result of diphtheria Supportive management to pregnant mothers with diphtheria to/Relieve common symptoms Relieve fever with anti pyretics/analgesics such as paracetamol and ibuprofen		Psycho social support to mothers who may have poor pregnancy outcomes due to diphtheria e.g low birth weight babies, preterm

Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Information and health education to parents, families and Communities on immunization including vaccination schedule for the young children Families and community education on transmission and prevention of Diphtheria Community education on proper nutrition for young children/under 5s Education on hygiene measures for young children Promoting proper planning especially in urban areas to avoid over-crowding through multi-sectoral approach Community health workers education on Diphtheria including recognition of signs and symptoms in children and on prevention measures	Routine vaccination for diphtheria according to the national schedule (use of Diphtheria toxoid-vaccine combined with tetanus toxoid (Td) as well with other antigens such as pertussis (DTwP/DTaP/Tdap) Proper Nutrition for children under 5 years of age Defaulter tracing for children who are not fully immunize Identify trends of the disease in the community/Active surveillance and early detection of diphtheria Record keeping/reporting Contact tracing for those in contact with infected persons Quarantine suspected cases 0utreach services to the communities Recording and reporting of diphtheria cases through established reporting mechanisms		Recognition of features of Diphtheria in under 5s which include: _ sore throat, low fever and swollen glands in the neck, a thick coating in the throat or nose, hoarse voice Supportive management for children under 5 years of age with Diphtheria Breastfeeding for the infants - Plenty of rest - Proper nutrition for a child with diphtheria Referral to a health facility of the child with worsening condition due to suspected diphtheria
Primary Care
Sensitize parents and care givers to recognize when the child is sick and when to seek treatment Sensitize parents and care givers regarding transmission and prevention of diphtheria in under 5s Information and health education to parents, families and on immunization including vaccination schedule Guidance to the parents and families on proper nutrition for the under 5s Training/sensitizing health workforce on diphtheria, its prevention and management in under 5s Update/training of health care workers on immunization as recommended in national immunization schedules.	Routine vaccination for diphtheria according to the national schedule (use of Diphtheria toxoid-vaccine combined with tetanus toxoid (Td) as well with other antigens such as pertussis (DTwP/DTaP/Tdap) Defaulter tracing for children who are not fully immunized Outreach services to the communities Active surveillance and early detection of diphtheria Contact tracing for under 5s who have been in contact with persons infected with diphtheria Post exposure vaccination for unvaccinated under 5s Prophylactic antibiotics (penicillin or erythromycin) for under 5s who have been in close contact with some with diphtheria Recording and reporting of diphtheria cases through established reporting mechanisms		History; Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria - including Supportive management to an under 5 with diphtheria to/Relieve common symptoms· Relieve fever with anti pyretics/analgesics such as paracetamol and ibuprofen Provide nutritional support for the under 5s with diphtheria Immunization with diphtheria toxoid vaccine for children who have not been vaccinated or have not completed the appropriate course Monitoring and recognition for any features of worsening of diphtheria in under 5s which includes, shortness of breath/breathing difficulties Physical and Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria including; - Fever Emergency care with an aim of stabilizing the under 5s with complications due to diphtheria before referral Referral of a child with diphtheria to a hospital
Referral Facility: General
Guidance to parents on prevention of diphtheria among children Guidance to parents on hygiene practices for children Education on importance of immunization for the children Guidance to parents on proper nutrition for children Health workers education on management of diphtheria among children	Identify close contacts such as caretakers, relatives, sexual contacts, friends; - Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Recording and reporting of diphtheria cases through established reporting mechanisms Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series		Physical and Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria including; - Fever Isolation. Respiratory droplet isolation of children under 5s with respiratory diphtheria and contact precautions for under 5s children with cutaneous diphtheria Antitoxin treatment with DAT immediately diphtheria is strongly suspected in children under 5 years (without waiting for lab results) Antibiotic treatment (penicillin or erythromycin) to eliminate the bacteria and toxin production Immunization with diphtheria toxoid vaccine during convalescence for children who have not been vaccinated/have not completed the appropriate course Tests, nasal/pharyngeal swabs for culture Monitor and management of any diphtheria complications such as obstruction of the airways, systemic diphtheria -to the heart, kidney or peripheral nerves Emergency management for diphtheria complication such as airway obstructions
Referral Facility: Specialist
Guidance to parents on hygiene practices for children Guidance to parents on prevention of diphtheria among children Education on importance of immunization for the children Guidance to parents on proper nutrition for children Health workers education on management of diphtheria among children	Identify close contacts such as caretakers, relatives, sexual contacts, friends; - Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Recording and reporting of diphtheria cases through established reporting mechanisms Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series		Physical and Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria including; - Fever Antitoxin treatment with DAT immediately diphtheria is strongly suspected in children under 5 years (without waiting for lab results) Antibiotic treatment (penicillin or erythromycin) to eliminate the bacteria and toxin production Immunization with diphtheria toxoid vaccine during convalescence for children who have not been vaccinated/have not completed the appropriate course Isolation. Respiratory droplet isolation of children under 5s with respiratory diphtheria and contact precautions for under 5s children with cutaneous diphtheria Tests, nasal/pharyngeal swabs for culture Monitor and management of any diphtheria complications such as obstruction of the airways, systemic diphtheria -to the heart, kidney or peripheral nerves Emergency management for diphtheria complication such as airway obstructions

Age Cohort: 5 - 11 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Information/education on transmission and prevention of Diphtheria Education on proper nutrition for primary school age children - Proper sanitation - School health program Community health workers education on Diphtheria including recognition of signs and symptoms in primary school age children and on prevention measures	Vaccination-booster doses of diphtheria toxoid-containing vaccine Contact tracing for primary school age children who have been in contacts with patients with Diphtheria Quarantine for contacts		Recognition of features of worsening condition due to diphtheria – such as shortness of breath Supportive management for primary school age children with Diphtheria - Plenty of rest Proper nutrition for a child with diphtheria Recognition of features of Diphtheria in primary school age children which include: _ sore throat, low fever and swollen glands in the neck, a thick coating in the throat or nose, hoarse voice Referral to a health facility of the child with suspected diphtheria
Primary Care
Information/education on transmission and prevention of diphtheria Creation of awareness on importance on immunization Education on proper nutrition for school age children School health programs Provision of IEC materials through schools and communities Training/sensitizing health workforce on diphtheria and its management Training health workforce Update/training of health care workers on immunization as recommended in national immunization schedules.	Routine vaccination (booster vaccination) for diphtheria according to the national schedule Active surveillance and early detection of diphtheria (use of Diphtheria toxoid-vaccine combined with tetanus toxoid (Td) as well with other antigens such as pertussis (DTwP/DTaP/Tdap) Identify close contacts such as caretakers, relatives, sexual contacts, friend, Health care workers Prophylactic antibiotics (penicillin or erythromycin) for close contacts Monitor close contacts for signs and symptoms of diphtheria Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series Recording and reporting of diphtheria cases through established reporting mechanisms
Referral Facility: General
Guidance to school children on prevention of diphtheria Education on importance of immunization Guidance to school children on hygiene practices Guidance to school children on proper nutrition Health workers education on management of diphtheria among primary school age children	Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series Recording and reporting of diphtheria cases through established reporting mechanisms		Physical and Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria including; - Fever Tests, Nasal/pharyngeal swabs for culture Antitoxin treatment with DAT immediately diphtheria is strongly suspected in school age children (without waiting for lab results) Antibiotic treatment (penicillin or erythromycin) to eliminate the bacteria and toxin production Immunization with diphtheria toxoid vaccine during convalescence for school age children who are immunised/have not completed the appropriate course Isolation. Respiratory droplet isolation of school age children with respiratory diphtheria and contact precautions for those with cutaneous diphtheria Monitor and management of any diphtheria complications such as obstruction of the airways, systemic diphtheria -to the heart, kidney or peripheral nerves Emergency management for diphtheria complication such as airway obstructions
Referral Facility: Specialist
Guidance to school children on prevention of diphtheria Education on importance of immunization Guidance to school children on hygiene practices Guidance to school children on proper nutrition Health workers education on management of diphtheria among primary school age children	Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Recording and reporting of diphtheria cases through established reporting mechanisms Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series		Tests, Nasal/pharyngeal swabs for culture Antitoxin treatment with DAT immediately diphtheria is strongly suspected in school age children (without waiting for lab results) Antibiotic treatment (penicillin or erythromycin) to eliminate the bacteria and toxin production Immunization with diphtheria toxoid vaccine during convalescence for school age children who are immunised/have not completed the appropriate course Isolation. Respiratory droplet isolation of school age children with respiratory diphtheria and contact precautions for those with cutaneous diphtheria Monitor and management of any diphtheria complications such as obstruction of the airways, systemic diphtheria -to the heart, kidney or peripheral nerves Physical and Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria including; - Fever

Age Cohort: 12 - 24 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Adolescents and Families education on transmission and prevention of Diphtheria Community education on proper nutrition for adolescents Proper sanitation Promoting proper planning especially in urban areas to avoid over-crowding through multi sector al approach Community health workers education on Diphtheria including prevention and recognition of signs of Diphtheria adolescents			Recognition of features of Diphtheria in adolescents which include: _ sore throat, low fever and swollen glands in the neck, a thick coating in the throat or nose, hoarse voice Supportive management for adolescents with Diphtheria - Plenty of rest Proper nutrition for adolescents with diphtheria Recognition of features of worsening condition due to diphtheria – such as shortness of breath Referral to a health facility of adolescent with suspected diphtheria
Primary Care
Information/education on transmission and prevention of diphtheria Creation of awareness on importance on immunization Education on proper nutrition for school age children School health programs Provision of IEC materials through schools and communities Training/sensitizing health workforce on diphtheria and its management Update/training of health care workers on immunization as recommended in national immunization schedules	Routine vaccination (booster vaccination) for diphtheria according to the national schedule Active surveillance and early detection of diphtheria (use of Diphtheria toxoid-vaccine combined with tetanus toxoid (Td) as well with other antigens such as pertussis (DTwP/DTaP/Tdap) Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Recording and reporting of diphtheria cases through established reporting mechanisms		History and Clinical examination and diagnosis of diphtheria in school age children -based on signs and symptoms of diphtheria - including - Fever Supportive management to school age children with diphtheria to Relieve common symptoms Relieve fever with anti pyretics/analgesics such as paracetamol and ibuprofen Immunization with diphtheria toxoid vaccine for school age children who have not been vaccinated or have not completed the appropriate course Provide nutritional support for the school age children with diphtheria Monitoring and recognition for any features of worsening of diphtheria in school age children which includes Emergency care with an aim of stabilizing the child with complications due to diphtheria before referral Shortness of breath/breathing difficulties Referral of the child with diphtheria to a hospital
Referral Facility: General
Guidance to adolescents on prevention of diphtheria Guidance to adolescents on hygiene practices Education on importance of immunization Guidance to adolescents on proper nutrition Health workers education on management of diphtheria among adolescents	Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series Recording and reporting of diphtheria cases through established reporting mechanisms		History Clinical examination Isolation Respiratory droplet isolation of adolescents patients with respiratory diphtheria and contact precautions for those with cutaneous diphtheria Antitoxin treatment with DAT immediately diphtheria is strongly suspected in adolescents (without waiting for lab results) Antibiotic treatment (penicillin or erythromycin) to eliminate the bacteria and toxin production Immunization with diphtheria toxoid vaccine during convalescence for adolescents who have not been immunized previously/have who had not completed the appropriate course Tests, nasal/pharyngeal swabs for culture Physical and Clinical examination and diagnosis of diphtheria in children under 5 years Monitor and management of any diphtheria complications such as obstruction of the airways, systemic diphtheria -to the heart, kidney/peripheral nerves of age. -based on signs and symptoms of diphtheria including; - Fever Emergency management for diphtheria complication such as airway obstructions
Referral Facility: Specialist
Guidance to adolescents on hygiene practices Guidance to adolescents on prevention of diphtheria Education on importance of immunization Guidance to adolescents on proper nutrition Health workers education on management of diphtheria among adolescents	Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Recording and reporting of diphtheria cases through established reporting mechanisms Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series		Tests, nasal/pharyngeal swabs for culture Antitoxin treatment with DAT immediately diphtheria is strongly suspected in adolescents (without waiting for lab results) Antibiotic treatment (penicillin or erythromycin) to eliminate the bacteria and toxin production Immunization with diphtheria toxoid vaccine during convalescence for adolescents who have not been immunized previously/have who had not completed the appropriate course< Isolation. Respiratory droplet isolation of adolescents patients with respiratory diphtheria and contact precautions for those with cutaneous diphtheria Monitor and management of any diphtheria complications such as obstruction of the airways, systemic diphtheria -to the heart, kidney/peripheral nerves Physical and Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria including; - Fever

Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Families and community education on transmission and prevention of Education on proper nutrition for adults Proper sanitation Promoting proper planning especially in urban areas to avoid over-crowding through multi sector al approach Community health workers education on diphtheria including prevention measure	Vaccination-booster doses of diphtheria toxoid-containing vaccine for adolescents Contact tracing Quarantine for contacts		Recognition of features of Diphtheria in adults which include: _ sore throat, low fever and swollen glands in the neck, a thick coating in the throat or nose, hoarse voice Supportive management for adults with Diphtheria - Plenty of rest Recognition of features of worsening condition due to diphtheria –such as shortness of breath Proper nutrition for adult with diphtheria Referral to a health facility of adult with suspected diphtheria
Primary Care
Information/education on transmission and prevention of diphtheria Creation of awareness on importance on immunization Education on proper nutrition for adults Provision of IEC materials through communities Creation of awareness on good hygiene practices Training/sensitizing health workforce on diphtheria and its management Update/training of health care workers on immunization as recommended in national immunization schedules.	Active surveillance and early detection of diphtheria Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin/erythromycin) for close contacts Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series Recording and reporting of diphtheria cases through established reporting mechanisms		History and Clinical examination and diagnosis of diphtheria in adults -based on signs and symptoms of diphtheria - including - Fever Supportive management to in adults with diphtheria to/Relieve common symptoms Relieve fever with anti pyretics/analgesics such as paracetamol and ibuprofen. Provide nutritional support for the adults with diphtheria Immunization with diphtheria toxoid vaccine for adults who have not been vaccinated or have not completed the appropriate course Monitoring and recognition for any features of worsening of diphtheria s in adults which includes Shortness of breath/breathing difficulties Emergency care with an aim of stabilizing the adults with complications due to diphtheria before referral Referral of adults with diphtheria to a hospital
Referral Facility: General
Guidance to adults on prevention of diphtheria Education on importance of immunization Guidance to adults on proper nutrition Guidance to adults on hygiene practices Health workers education on management of diphtheria among the adults	Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Recording and reporting of diphtheria cases through established reporting mechanisms Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series		Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series Recording and reporting of diphtheria cases through established reporting mechanisms
Referral Facility: Specialist
Guidance to adults on hygiene practices Guidance to adults on prevention of diphtheria Education on importance of immunization Guidance to adults on proper nutrition Health workers education on management of diphtheria among the adults	Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Recording and reporting of diphtheria cases through established reporting mechanisms Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series		Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Recording and reporting of diphtheria cases through established reporting mechanisms Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series

Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Information to Families and community education on transmission and prevention of diphtheria Awareness creation on hygiene measures Community education on proper nutrition for the elderly Proper sanitation Promoting proper planning especially in urban areas to avoid over-crowding Community health workers education on diphtheria including prevention measures	Vaccination-booster doses of diphtheria toxoid-containing vaccine for adolescents Contact tracing Quarantine for contacts		Recognition of features of Diphtheria in the elderly which include; _ sore throat, low fever and swollen glands in the neck, a thick coating in the throat or nose, hoarse voice Supportive management for the elderly with Diphtheria - Plenty of rest Proper nutrition for elderly with diphtheria Recognition of features of worsening condition due to diphtheria –such as shortness of breath Referral to a health facility of the elderly with suspected diphtheria
Primary Care
	Information/education on transmission and prevention of diphtheria Creation of awareness on importance on immunization Education on proper nutrition for elderly Creation of awareness on good hygiene practices Provision of IEC materials Training/sensitizing health workforce on diphtheria and its management		Physical and Clinical examination and diagnosis of diphtheria in the elderly based on signs and symptoms of diphtheria; including - Fever Supportive management to elderly with diphtheria to /Relieve common symptoms Relieve fever with anti pyretics/analgesics such as paracetamol and ibuprofen Provide nutritional support for the elderly with diphtheria Immunization with diphtheria toxoid vaccine for elderly who have not been vaccinated or have not completed the appropriate course Monitoring and recognition for any features of worsening of diphtheria s in elderly which includes,shortness of breath/breathing difficulties Emergency care with an aim of stabilizing the elderly with complications due to diphtheria before referral Referral of elderly persons with diphtheria to a hospital
Referral Facility: General
Guidance to elderly on prevention of diphtheria Education on importance of immunization Guidance to elderly on proper nutrition Guidance to the elderly on hygiene practices Health workers education on management of diphtheria among elderly	Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin/erythromycin) for close contacts Recording and reporting of diphtheria cases through established reporting mechanisms Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series		Tests, Nasal/pharyngeal swabs for culture Physical and Clinical examination and diagnosis of diphtheria in the elderly -based on signs and symptoms of diphtheria; including - Fever Antitoxin treatment with DAT immediately diptheria is strongly suspected in the elderly (without waiting for lab results) Antibiotic treatment (penicillin or erythromycin) to eliminate the bacteria and toxin production Immunization with diphtheria toxoid vaccine during convalescence for elderly who had not completed the appropriate course Isolation. Respiratory droplet isolation of elderly patients with respiratory diphtheria and contact precautions for those with cutaneous diphtheria Monitor and management of any diphtheria complications such as obstruction of the airways, systemic diphtheria -to the heart, kidney or peripheral nerves Emergency management for diphtheria complication such as airway obstructions
Referral Facility: Specialist
Guidance to elderly on prevention of diphtheria Education on importance of immunization Guidance to elderly on proper nutrition Guidance to the elderly on hygiene practices Health workers education on management of diphtheria among elderly	Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin/erythromycin) for close contacts Recording and reporting of diphtheria cases through established reporting mechanisms Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series		Tests, Nasal/pharyngeal swabs for culture Physical and Clinical examination and diagnosis of diphtheria in the elderly -based on signs and symptoms of diphtheria; including - Fever Antitoxin treatment with DAT immediately diptheria is strongly suspected in the elderly (without waiting for lab results) Antibiotic treatment (penicillin or erythromycin) to eliminate the bacteria and toxin production Immunization with diphtheria toxoid vaccine during convalescence for elderly who had not completed the appropriate course Isolation. Respiratory droplet isolation of elderly patients with respiratory diphtheria and contact precautions for those with cutaneous diphtheria Monitor and management of any diphtheria complications such as obstruction of the airways, systemic diphtheria -to the heart, kidney or peripheral nerves Emergency management for diphtheria complication such as airway obstructions