Skip to main content

Diphtheria, tetanus, pertussis (whooping cough) and polio (dTaP/IPV or 4-in-1) - Information for health professionals

On this page

 

Background

Diphtheria, tetanus, pertussis (whooping cough) and poliomyelitis are notifiable diseases.

Diphtheria

Diphtheria is an acute infection usually affecting the nasopharynx caused by the bacterium Corynebacterium diphtheriae, and can affect all ages. The organism is spread by respiratory droplets and has an incubation period of two to five days.

Tetanus

Tetanus is an infection characterised by painful muscular contractions. It is caused by the bacterium Clostridium tetani and can affect any age. The organism is ubiquitous in the environment and has an incubation period from one day to several months.

Pertussis (whooping cough)

Pertussis is a respiratory infection characterised by sudden and severe spasms of coughing persisting for several weeks. It is caused by the bacterium Bordetella pertussis which can affect all ages, but is particularly severe in babies and infants, and can cause brain damage due to hypoxia during paroxysms of coughing. The organism is spread by direct contact or airborne respiratory droplets, and has an incubation period of 6 – 20 days.

Poliomyelitis

Polio (Poliomyelitis) is an infection characterised by the acute onset of flaccid paralysis. It is caused by Poliovirus type 1, 2 or 3, and can affect all ages. The organism is spread by the faecal-oral route and has an incubation period of 7 – 14 days.

The vaccine

Boostrix-IPV is an inactivated injectable vaccine in a pre-filled syringe presentation. Boostrix-IPV contains reduced content of diphtheria, tetanus and pertussis antigens in combination with poliomyelitis antigens.

Boostrix-IPV (‘4-in-1’) can be used in the management of tetanus prone injuries in persons.

Guidance on the treatment of tetanus cases and management of tetanus prone wounds can be is available at Tetanus: advice for health professionals.

Tetanus immunoglobulin should be administered concomitantly in accordance with official recommendations.

Summary of product characteristics

The Complete Routine Immunisation Schedule (PDF) includes information about routine and non-routine vaccinations.

 

Guidance

Vaccination programme recommendations from the Joint Committee on Vaccination and Immunisation (JCVI) and Welsh Government policy can be found at the links below.

Joint Committee on Vaccination and Immunisation - GOV.UK (read JCVI publications and statements; search e.g. polio)

Welsh Health Circulars and Welsh Government letters

Pertussis vaccination for healthcare workers (WHC/2019/024) | GOV.WALES

Change to the pertussis vaccination programme for pregnant women (WHC/2016/020) | GOV.WALES

Children who have outstanding routine immunisations: national enhanced service specification (WHC/2017/021) | GOV.WALES

NES - Unscheduled Immunisations for Children and Young Adults

 

Training resources and events

Online courses and training materials about a number of vaccines and diseases can be accessed via the E-learning page.

Further immunisation training information and resources are provided on the Training Resources and Events page.

 

Clinical resources and information

Diphtheria –the green book, chapter 15

Tetanus – the green book, chapter 30 

Pertussis - the green book, chapter 24

Polio – the green book, chapter 26

Tetanus: advice for health professionals

Vaccination of individuals with uncertain or incomplete immunisation status (UKHSA)

Patient group directions (PGDs) and protocols

PGD templates for vaccines can be found on the Patient group directions (PGDs) and protocols page.

Further clinical resources and information

 

Data and surveillance

Vaccination surveillance information can be found on the pages below: