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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.
Diagnosis
Healthcare providers diagnose diphtheria by assessing symptoms and conducting lab tests, typically using a throat swab to collect samples from the back of the throat or a sore. These samples are sent to a lab for analysis. Diphtheria may be suspected in a child displaying symptoms such as a sore throat with a gray membrane covering the tonsils and throat. Confirmation of the diagnosis involves detecting the growth of C. diphtheriae in a lab culture from the throat membrane. Additionally, doctors can test tissue samples from infected wounds to identify the specific type of diphtheria affecting the skin (cutaneous diphtheria). Treatment for diphtheria is initiated promptly upon suspicion, even before receiving bacterial test results.
Treatment
Diphtheria is a severe illness that requires immediate and aggressive medical intervention. The primary focus for doctors is ensuring that the airway remains unobstructed. In certain cases, a breathing tube may be inserted into the throat to maintain an open airway until inflammation subsides. Treatment modalities include:
- Antibiotics: Medications such as penicillin or erythromycin are administered to eliminate bacteria in the body, hastening the resolution of the infection. This not only aids the patient’s recovery but also reduces the contagious period.
- Antitoxin: When diphtheria is suspected, doctors may administer an antitoxin to counteract the diphtheria toxin. This medication, sourced from the Centers for Disease Control and Prevention, is typically injected into a vein or muscle. Before administering the antitoxin, doctors may conduct skin allergy tests to ensure the patient has no adverse reactions. If an allergy is detected, alternative treatment options are explored.
Hospitalization is often necessary for both children and adults with diphtheria. In some cases, isolation in an intensive care unit is recommended due to the ease with which diphtheria can spread to non-vaccinated individuals.
Preventive treatment
If you have been exposed to someone with diphtheria, seeking prompt medical attention is crucial. The doctor may prescribe antibiotics as a preventive measure against developing the disease. Additionally, a booster dose of the diphtheria vaccine might be recommended.
Individuals identified as carriers of diphtheria undergo antibiotic treatment to eradicate the bacteria from their systems. Regular testing and preventive measures play a crucial role in managing and curbing the spread of this potentially deadly disease.
