Risk factors for diphtheria: A prospective case-control study in the Republic of Georgia, 1995-1996

The large-scale resurgence of diphtheria in the former Soviet Union offered a unique opportunity to evaluate risk factors for the transmission of resp iratory diphtheria; therefore, a prospective case-control study was done in the republic of Georgia. In total, 218 diphtheria cases (hospitalized betw een October 1995 and March 1996) and 408 matched controls participated, One hundred cases (45%) were less than or equal to 14 years of age, and 118 (5 5%) were greater than or equal to 15 years of age (range: <1 to 75 years). In the multivariate analyses, the following risk factors were found to be s ignificant: lack of vaccination (matched odds ratio [mOR] = 19.2), househol d exposure to diphtheria (mOR = 7.4), exposure to skin lesions (mOR = 5.8), history of eczema (mOR = 3.4), fever with myalgia prior to illness (mOR = 2.6), having tonsils (mOR = 4.4), sharing a bed (mOR = 1.9), sharing cups a nd glasses (mOR = 2.7), and taking a bath less than once a week (mOR = 2.6) , These findings emphasize primary prevention through immunizations, second ary prevention following exposure to diphtheria land to suspicious skin les ions), and adherence to strict standards of personal hygiene.