Diphtheria

Diphtheria is an infection caused by bacteria. It is extremely contagious and spreads very quickly, affecting the throat and the nasal passages. People who are most likely to contract diphtheria include elderly adults, young children under the age of five, and people with compromised immune systems. Fortunately, cases of diphtheria are rare in the western world as an immunization program implemented in the past 30 years has been successful in nearly eradicating the disease. Diphtheria is still a threat in developing countries, especially where immunizations aren’t regularly distributed.

Symptoms

The symptoms of a diphtheria infection might initially seem similar to a sore throat. Some people might notice a mild fever or swollen lymph nodes. Most often, these symptoms are mistaken as being caused by the common cold, strep throat, or the flu. However, as the infection progresses, it creates a thick membranous coating in the airway, throat, and nose. This symptom is noticeably different from other infections, as it is dark in color and appears to be fuzzy. This membrane makes it difficult for someone with diphtheria to swallow and in some cases, breathe.

As the disease continues to run its course, other symptoms usually appear. These may include double vision, slurring of speech, bluish-colored skin, watered-down nasal excretions of blood, increases in heart rate, cough, drooling, fever, and skin lesions. If the diphtheria infection progresses, it can affect other areas of the body, including the organs and the skin. In nearly half of all cases, those who are not treated will die.

Causes

Diphtheria infections are caused by a bacterium called Corynebacterium diphtheriae. These bacteria multiply on the throat’s mucous membranes. They are transferred from person to person one of two ways. The first mode of transmission is via infected airborne water droplets. Someone who has diphtheria and then coughs or sneezes can project water droplets carrying the disease, which are then inhaled and can infect others. In countries where crowding is a problem, this is the disease’s main route of transmission.

Diphtheria can also be contracted through direct contact with items that have been contaminated with bacteria. Contaminated objects could include used napkins, tissues, or a glass that a diphtheria-infected person used. This mode of transmission is rarer, but in unhygienic conditions it can be a problem. Occasionally, items such as used towels, sheets, or toys can also spread the disease.

Infected persons can transmit the disease for up to six weeks, both before and after they show symptoms.

Prevention

According to the Mayo Clinic, the only way to both protect and treat diphtheria is by getting the vaccine. Today, the vaccine is usually administered in combination with vaccines to protect against pertussis, or whooping cough, and tetanus. The child version is known as the DTaP (diphtheria-tetanus-pertussis) but there is another version available for adults who were not vaccinated as children, called Tdap.

DTaP is usually administered in five doses, which are most often injected into the side of the arm or the thigh. The doses are administered to infants at the age of two months, four months, six months, between 12 and 18 months, and finally between four and six years of age. Boosters are recommended after a six year interval initially and after a ten year interval afterward. Boosters are the only way to ensure continued immunity. If you are traveling to an area of the world where diphtheria is a threat, you should make sure that your immunization record is up-to-date.

Treatment

When someone is diagnosed with diphtheria, it must be treated as quickly and as aggressively as possible. There are two medications commonly used for treatment: antitoxins and antibiotics. Antitoxins are given immediately after a diagnosis. They are injected into a vein to deactivate circulating toxins. In some cases, patients have allergies to the antitoxin medication and it must be administered in increasing doses.

Antibiotics, including erythromycin and penicillin, remove bacteria that has accumulated in the body as a result of the infection. These drugs greatly reduce the period that the disease can be transferred by the infected person.