Who should receive DAT?

Therapeutic Use
Patients who have probable or confirmed respiratory diphtheria are eligible to receive DAT.

Clinical Respiratory Diphtheria is defined as an upper respiratory tract illness characterized by sore throat, a low grade fever, and an adherent membrane of the tonsil(s), pharynx, larynx, and/or nose.

A confirmed case is either a clinical case from which C. diphtheria is isolated or a clinical case that is epidemiologically linked to a laboratory-confirmed case.

A probable case is a clinically compatible case that is not laboratory confirmed and is not epidemiologically linked to a laboratory-confirmed case.

Prophylactic Use
DAT is used prophylactically only under exceptional circumstances involving known or suspected exposure to toxigenic Corynebacteria.

For more detailed information about case definitions and DAT use, see IND Protocol #4166, "Use of Diphtheria Antitoxin (DAT) for Suspected Diphtheria Cases."

Top

How to request DAT
U.S. physicians caring for patients with suspected respiratory diphtheria can obtain DAT by contacting the diphtheria duty officer at C CDC's Meningitis and Vaccine Preventable Disease Branch in the Division of Bacterial Diseases, of the National Center for Immunization and Respiratory Diseases (Proposed) (telephone, 404-639-3158) from 8 a.m. to 4:30 p.m. Eastern time or from the Emergency Operations Center (telephone, 770-488-7100) at all other times. The diphtheria duty officer will discuss the case and protocol with the physician and, if indicated, DAT will be rushed from one of the U.S. Public Health Service quarantine stations. A patient's eligibility for treatment with DAT is determined by the treating physician in consultation with a CDC diphtheria duty officer. However, the treating physician makes the final decision. The physician may decide against using DAT after it is released.

Top

How to return unused DAT
If the patient’s diagnosis is revised after the release of DAT and the diphtheria antitoxin (DAT) is not given to the patient, then it should be returned in a cold pack by overnight mail to:

CDC Drug Service (Mailstop D-09)
Centers for Disease Control and Prevention
1600 Clifton Road, Atlanta Georgia 30333
Phone: (404) 639-3717

Top

Forms and Worksheets

DAT IND Protocol (FDA Approved) UPDATED! print version (.pdf) text-only (screen-reader version) (.doc)

Consent form UPDATED! print version (.pdf) text-only (screen-reader version) (.doc)

Diphtheria Investigation Worksheet print version (.pdf) Not acceptable for screen-reader devices, please contact NIPINFO@cdc.gov for immediate assistance.

Close contacts worksheet print version (.pdf) Not acceptable for screen-reader devices, please contact NIPINFO@cdc.gov for immediate assistance.

Adverse event worksheet print version (.pdf) Not acceptable for screen-reader devices, please contact NIPINFO@cdc.gov for immediate assistance.

Laboratory DASH NEW! print version (.pdf) Not acceptable for screen-reader devices, please contact NIPINFO@cdc.gov for immediate assistance.

Laboratory instructions for specimen collection and transportation UPDATED! print version (.pdf) text-only (screen-reader version) (.doc)

Diphtheria Diagnosis Checklist UPDATED! Provides some guidance on the factors to consider while assessing the probability of respiratory diphtheria, and a list of other disease agents to consider in the differential diagnosis of respiratory diphtheria print version (.pdf) text-only (screen-reader version) (.doc)

FDA 1572 Form NEW! print version (.doc) Not acceptable for screen-reader devices, please contact NIPINFO@cdc.gov for immediate assistance.

Top

Reading Resources (Journal article references, book chapters, etc.)

Pink Book's chapter on Diphtheria ("Epidemiology and Prevention of Vaccine-Preventable Diseases" textbook) print/view version (.pdf) text-only (screen-reader version) (.rtf)

Surveillance manual's chapter on Diphtheria ("Surveillance of Vaccine-Preventable Diseases" manual) print/view version (.pdf)   NOTE: Text-only versions for screen-reader devices can be obtained from NIPINFO.

MMWR Articles

Preventing Tetanus, Diphtheria, and Pertussis Among Adults: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine NEW! MMWR December 15, 2006 / Vol 55, No. RR-17 General Recommendations on Immunization NEW! MMWR December 1, 2006 / Vol 55, No. RR-15 Preventing Tetanus, Diphtheria, and Pertussis Among Adolescents: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines NEW! MMWR March 24, 2006 / Vol 55, No. RR-3 Availability of Diphtheria Antitoxin Through an Investigational New Drug Protocol MMWR May 21, 2004 / Vol 53, No. 19, p413 Fatal Respiratory Diphtheria in a U.S. Traveler to Haiti -- Pennsylvania, 2003 NEW! MMWR January 9, 2004 / Vol 52 (53);1285-1286 Combination Vaccines for Childhood Immunization MMWR May 14, 1999 / Vol 48, No. RR05, p1 Toxigenic Corynebacterium diphtheriae -- Northern Plains Indians MMWR June 6, 1997 / Vol 46, No. 22, p506 Diphtheria, Tetanus, and Pertussis: Recommendations for Vaccine Use MMWR August 8, 1991 / Vol 40, No. RR10, p001

Top

Other Resources

DAT-Release Cover Letter for Physicians NEW! print/view version (.pdf) Not acceptable for screen-reader devices, please contact NIPINFO@cdc.gov for immediate assistance.

Guide to Skin-testing for Sensitivity to Diphtheria Antitoxin NEW! print/view version (.pdf) Not acceptable for screen-reader devices, please contact NIPINFO@cdc.gov for immediate assistance.

List of quarantine stations: http://www.cdc.gov/ncidod/dq/quarantine_stations.htm

Immunization program managers: http://www2a.cdc.gov/nip/progmgr/fieldstaff.asp?rpt=pm

Web Link to list of State Epidemiologists: (exit site) http://www.cste.org/members/state_and_territorial_epi.asp

*Accessibility Note: For those materials not available in formats acceptable for screen-reader devices, please contact NIPINFO@cdc.gov for immediate assistance.

This page last modified on January 25, 2007
Content on this page last reviewed on January 25, 2007