Diphtheria

Overview

Diphtheria, a contagious infection caused by the bacterium Corynebacterium diphtheria, is a serious bacterial illness predominantly affecting the mucous membranes of the nose and throat. The bacterium produces a toxin that results in the formation of grey tissue in the throat, leading to difficulties in swallowing and breathing.

While diphtheria can be treated with medications, regions with limited healthcare or vaccination access still witness elevated rates of this infection. In its advanced stages, diphtheria can inflict damage on vital organs such as the heart, kidneys, and nervous system. Even with prompt treatment, diphtheria carries a significant risk of fatality, particularly among children.

Symptoms

Diphtheria typically manifests its signs and symptoms within 2 to 5 days following infection.

Common indications include:

• Thick, gray membrane: The presence of a dense, gray membrane covering the throat and tonsils.
• Sore throat and hoarseness: Uncomfortable throat sensations and changes in voice.
• Swollen glands: Enlarged lymph nodes in the neck.
• Difficulty breathing: Labored or rapid breathing.
• Nasal discharge: Ongoing discharge from the nose.
• Fever and chills: Elevated body temperature accompanied by chills.
• Tiredness: Fatigue and overall lethargy.

Some individuals may experience only mild symptoms or be entirely asymptomatic, becoming carriers of the bacteria and unknowingly spreading the infection. Carriers can transmit the disease without displaying noticeable signs.

Additionally, there is a variation known as skin (cutaneous) diphtheria. This form can affect the skin, causing redness, swelling, and pain akin to other bacterial skin infections. The presence of ulcers covered by a gray membrane may indicate skin diphtheria.

Contact your doctor promptly if you or your child has been in close contact with someone diagnosed with diphtheria. If you are uncertain about your child’s vaccination status for diphtheria, arrange a consultation with your healthcare provider. Additionally, ensure that your own vaccinations are up-to-date.

Causes

Diphtheria is the result of infection by the bacterium Corynebacterium diphtheriae, typically multiplying on or near the throat or skin surface. The transmission of C. diphtheriae occurs through:

• Airborne droplets: When an infected individual sneezes or coughs, releasing a mist of contaminated droplets, those in close proximity may inhale C. diphtheriae. This method of transmission is particularly effective in crowded conditions.
• Contaminated personal or household items: Diphtheria can be contracted by handling items belonging to an infected person, such as used tissues or hand towels, which may be contaminated with the bacteria. Touching an infected wound can also transfer the diphtheria-causing bacteria.

Individuals infected with the diphtheria bacteria, if untreated, can transmit the infection to those who haven’t received the diphtheria vaccine, even if they are asymptomatic.

Risk factors

Increased risk of diphtheria is associated with various factors, including:

• Lack of vaccination: Individuals, both children, and adults, who have not received up-to-date vaccinations are more susceptible to diphtheria.
• Living conditions: People residing in crowded or unsanitary environments face an elevated risk of contracting diphtheria.
• Travel to endemic areas: Those traveling to regions where diphtheria infections are more prevalent are at an increased risk.

While diphtheria is uncommon in the United States and Western Europe due to widespread vaccination, it remains a concern in developing nations with lower vaccination rates. In areas where vaccination is standard, the primary threat is to individuals who are either unvaccinated or inadequately vaccinated, particularly if they travel internationally or come into contact with people from less developed countries.