Skin infections and the epidemiology of diphtheria: acquisition and persistence of C diphtheriae infections.

Acquisition and persistence of C. diphtheriae infections of skin lesions and of the respiratory tract were observed in households exposed to C. diphtheriae carriers in a community experiencing a diphtheria outbreak and in households in two communities free of the disease. Acquisition of C. diphtheriae was more frequent in epidemic households, apparently due to a greater frequency of respiratory tract acquisition. Skin lesion acquisition was constant in both situations. The pattern of persistence appeared to be the same in both types of households, although skin lesion C. diphtheriae infections had a greater tendency to persist than respiratory tract infections. Acquisition occurred more frequently following exposure to a skin lesion C. diphtheriae carrier than following a respiratory carrier exposure.