What You Should Know About... Diphtheria in the Child Care Setting Diphtheria is a disease caused by a bacteria, Corynebacterium diphtheriae, which invades the throat. Diphtheria is usually spread through the airborne route or through contact with saliva or nasal secretions of an infected person. Up-to-date vaccination with the DTP (diphtheria is the “D”) vaccine can prevent this very serious, life-threatening disease. Because almost all children are vaccinated, diphtheria is now rare in the United States. However, some children are not adequately vaccinated and cases still can occur. To prevent its spread in a child care setting: Review immunization records of all children upon admission and periodically thereafter. Any child whose immunizations are incomplete or not up-to-date should be referred to the health department or the child's physician for proper immunization. Upon notification by a parent or health care worker that a child absent from the child care setting has contracted diphtheria, immediately contact the local health department for instructions on preventive measures to be taken. The local health department may advise caregivers to closely observe all children and adults in the child care setting for sore throats for 7 days (the incubation period), request that anyone developing a sore throat see a physician, prescribe antibiotics for close contacts, and carefully observe group separation and good hygiene procedures.