airflow and decreases the partial pressure of oxygen in the systemic circulation, which can cause cyanosis and suffocation. Transmission Mode of transmission is person-to-person contact via respiratory droplets (i.e., coughing or sneezing), and less commonly, by touching open sores or contaminated surfaces. Vaccine A vaccine, DTaP, effectively prevents the disease and is mandatory in the United States for participation in public education and some professions (exceptions apply). The invention of the toxoid vaccine, which provides protection against Corynebacterium diphtheriae, caused a dramatic shift on the bacterium's rate of infection in the United States. Even though the vaccine was first made in the early 1800s, it did not become widely available until the early 1910s. According to the National Health and Nutrition Examination Survey (NHANES), "80 percent of persons age 12 to 19 years were immune to diphtheria" due to the wide use of the vaccine in the United States. Diagnosis Diagnosis of respiratory C. diphtheriae is made based on presentation clinically, whereas non-respiratory diphtheria may not be clinically suspected therefore laboratory testing is more reliant. Culturing is the most accurate kind of testing that will confirm or deny the prevalence of diphtheria toxins. The testing is done by swabbing the possibly infected area, as well as any lesions and sores. Treatment and prevention When a toxigenic strain of Corynebacterium diphtheriae infects the human body, it releases harmful toxins, especially to the throat. Antitoxins are used to prevent further harm. Antibiotics are also used to fight the infection. Typical antibiotics that are used against diphtheria involve penicillin or erythromycin. People infected with diphtheria must quarantine for at least 48 hours after being prescribed antibiotics. To confirm that the person is no longer contagious, tests are performed ensure that the bacteria have been cleared. People are then vaccinated prevent further transmission of the disease. The wide-use of the diphtheria vaccine dramatically decreased the rate of infection and allows for primary prevention of the disease. Most people receive a 3-in-1 vaccine that consist of protection against diphtheria, tetanus and pertussis, which is commonly knowns as the DTaP or Tdap vaccine. DTaP vaccine is for children while the Tdap vaccine is known for adolescents and adults. In the United States, the DTaP vaccine to parents of infants which typically involves a series of five shots is recommended. These vaccines are injected through the arm or thigh and are administered when the infant is 2