What exactly is Diphtheria? Overview :

This is a disease which generally occurs in children of 1-5 years of age. Diphtheria is a serious bacterial infection that affects the mucous membranes of the throat and nose. Although it spreads easily from one person to another, diphtheria can be prevented through the use of vaccines.

Call your doctor right away if you believe you have diphtheria. If it’s left untreated, it can cause severe damage to your kidneys, nervous system, and heart. It’s fatal in about 3 percent of cases, according to the MayoClinic.

 

Some Common Information about Diphtheria:

Pathogen of Diphtheria: Rod-shaped bacterium (Cornybacterium diphtherea)
Mode of Transmission of Diphtheria: Through air (droplet infection)
Incubation period of Diphtheria: 2-4 days

Symptoms of Diphtheria:

  1. Slight fever, Sore throat and general indisposition.
  2. Oozing semisolid material in the throat which develops into a tough membrane. The membrane may cause clogging (blocking) of air passage, resulting into death.

Prevention and cure :

  1. Immediate medical attention should be given.
  2. Babies should be given DPT vaccine.
  3. Sputum, oral and nasal discharges of the infected child should be disposed off.
  4. Antibiotics may be given under doctor’s supervision.
  5. Isolation of the infected child.
 

Causes :

Diphtheria is an infectious disease caused by the bacterial microorganism known as Corynebacterium diphtheriae. Other Corynebacterium species can be responsible, but this is rare. Some strains of this bacterium produce a toxin, and it is this toxin that causes the most serious complications of diphtheria. The bacteria produce a toxin because they themselves are infected by a certain type of virus called a phage.

The toxin that is released:

  1. inhibits the production of proteins by cells
  2. destroys the tissue at the site of the infection
  3. leads to membrane formation
  4. gets taken up into the bloodstream and distributed around the body’s tissues
  5. causes inflammation of the heart and nerve damage
  6. can cause low platelet counts, or thrombocytopenia, and produce protein in the urine in a condition called proteinuria

What are the risk factors?

Children in the United States and Europe are routinely vaccinated against diphtheria, so the condition is rare in these places. However, diphtheria is still fairly common in developing countries where immunization rates are low. In these countries, children under age 5 and people over age 60 are particularly at risk of getting diphtheria. People are also at an increased risk of contracting diphtheria if they: aren’t up to date on their vaccinations visit a country that doesn’t provide immunizations have an immune system disorder, such as AIDS live in unsanitary or crowded conditions

Diagnosis:

There are definitive tests for diagnosing a case of diphtheria, so if symptoms and history cause a suspicion of the infection, it is relatively straightforward to confirm the diagnosis.
Doctors should be suspicious when they see the characteristic membrane, or patients have unexplained pharyngitis, swollen lymph nodes in the neck, and low-grade fever.
Hoarseness, paralysis of the palate, or stridor (high-pitched breathing sound) are also clues.

Tissue samples taken from a patient with suspected diphtheria can be used to isolate the bacteria, which are then cultured for identification and tested for toxicity:

  1. Clinical specimens are taken from the nose and throat.
  2. All suspected cases and their close contacts are tested.
  3. If possible, swabs are also taken from under the pseudomembrane or removed from the membrane itself.

The tests may not be readily available, and so doctors may need to rely on a specialist laboratory.

 

Treatment:

Treatment is most effective when given early, so a quick treatment of diphtheria is important. The antitoxin that is used cannot fight the diphtheria toxin once it has bound with the tissues and caused the damage.

Treatment of diphtheria is aimed at countering the bacterial effects has two components:

  1. Antitoxin – also known as anti-diphtheritic serum – to neutralize the                            toxin released by the bacteria.
  2. Antibioticserythromycin or penicillin to eradicate the bacteria and                                stop it from spreading.

Patients with respiratory diphtheria and symptoms would be treated in an intensive care unit in the hospital, and closely monitored. Healthcare staff may isolate the patient to prevent the spread of the infection.
This will be continued until tests for bacteria repeatedly return negative results in the days following the completion of the course of antibiotics.


Diphtheria Vaccine:

Diphtheria is one of the vaccine-preventable diseases; the most effective way to prevent diphtheria is to vaccinate people (infants, see below) early in their lives and to prevent infected individuals from coming in close contact with uninfected and/or non-immunized people. In addition, an infected person who is a carrier of the bacteria can be treated with antibiotics to eliminate the bacteria and thus reduce the chance of carriers transmitting bacteria to others. Notify disease control agents about any suspected infections that may be diphtheritic in origin.


Diphtheria tetanus vaccine:

There are vaccines available to protect individuals from diphtheria, and all formulations contain toxoid concentrations that stimulate antibody production against diphtheria toxin (D or d). These toxoid vaccinations also may contain acellular pertussis (aP or ap) and tetanus (T, tetanus toxoid) vaccine. They are as follows: DTaP, Tdap, DT, and Td. DTaP is the childhood vaccine, while Tdap is the adult vaccine. Perhaps the most important vaccine is DTaP, given at 2 months, 4 months, 6 months, 15-18 months, and 4-6 years of age.

DT does not contain pertussis, and health care providers administer it to children who have reacted to pertussis vaccine; Td is a vaccine for adolescents and adults given every 10 years as a booster for tetanus. Tdap has several formulations; the CDC in 2012 recommended that Tdap vaccine formulations be used as a booster dose to cover pertussis (whooping cough) instead of just the Td formulation against tetanus and diphtheria only. The side effects of these vaccines are usually mild such as pain or soreness at the injection site and/or a mild fever. These effects usually go away within a day. However, some patients do develop more severe symptoms; although this is infrequent, patients that do so should be aware of the reaction and inform any medical caregiver that they may have an allergy (for example, an allergy to tetanus or pertussis vaccine).

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Subin Joshua
Author: Hi there, my name is Subin Joshua, and I am a Medical student. I grew up in a family of teachers and know that being a social worker is my calling. My passion for helping others has been evident in my involvement in helping the poor and needy for the last three years. Through those experiences, I have learned to interact with a diverse group of people, which has increased my ability to relate to others.