Diphtheria: Causes, Symptoms, Treatment and Prevention

Diphtheria

 You might have heard of the six killer diseases of childhood as described by the world health organisation.  These six diseases are Polio, diphtheria, pertussis, tetanus, measles, and tuberculosis. They were the major cause of infant mortality or death rate in the past dating back to many years ago. The complications that these diseases caused are really fatal and so a Universal immunization schedule was proposed for all the kids under 5 and it showed good response to combat these infections.

Diphtheria is one of those killer disease which affects the children more commonly. It is a highly infectious and contagious air-borne disease affecting the nose and the mucous membranes of the body, caused by a bacterium known as Corynebacterium diphtheriae. This bacterium has a capacity to produce toxins in the human body and the toxigenic effect on the various major organs on the body may lead to a fatal outcome.

It is a serious illness which when left untreated can result into serious complications such as difficulty in breathing, myocarditis (inflammation of the myocardium of heart), affecting the nerves causing paralysis, other major organ failure such as lung, kidney or heart failures, or even death in some rare cases.

Diphtheria cases are nowadays not remarkably noted due to the massive immunization of the children under five. This has become possible due to the knowledge and willingness of the parents to immunize their kids.

Due to effective health education strategies, the combat against diphtheria has proven successful in fighting the deadly disease and reducing the infant and child mortality rate.

The infection is spread through the air via the droplets thrown or expelled out due to coughing and sneezing. The droplets contain the bacteria or bacterial spores that enter the body through air contact.

The symptoms usually arise after two to five days of infection. The symptoms can be mild, moderate or severe. The initial presentation occurs with the complain of sore throat which then progresses to fever and inflammation of the mucus membranes involving the nose, pharynx, tonsils etc.

Carriers of the infection:

Many infected persons who already have the bacteria present within their body, they do not show any signs and symptoms of the disease for more than many weeks. These persons still have the chances of spreading the infection to other persons within their contact through the droplets or touch. They are termed carriers of the disease or infection.

Types of diphtheria infection and its symptoms:

There are two common known types:

1.  Respiratory
2.  Cutaneous

 See also: Common cold and Asthma

Respiratory Diphtheria:

v The lymph nodes in the neck get enlarged in response to the infection within the body. These are mainly the diphtheria of respiratory type.

v The mode of transmission is via the inhalation of the contaminated air or droplets expelled out while coughing, sneezing, speaking or breathing.

v The main symptoms confine to the respiratory tract such as sore throat, inflamed tonsils and pharynx, runny nose, difficulty in swallowing food.

v Development of a grey-white layer or film over the mucus membranes of the nose, mouth, tonsils, palates, etc; as it grows  thicker it may create a blockage in the airway passage making it difficult for the person to breathe.

v Fever with chills and feeling of tiredness or weakness.

Cutaneous or skin diphtheria:

v In diphtheria of skin or cutaneous diphtheria, the organ involved is the skin. The skin is manifested by infectious lesions, especially ulcers.

v The initial occurrence of the lesion may be the eruption of a vesicle or some tiny pustule which then progresses to form an ulcer. The ulcers are formed due to the toxigenic effect of the bacteria onto the skin.

v These lesions can spread infection through skin contact to another person. It takes months for such lesions to heal.

v The ulcers may develop following some insect bites or damage to skin integrity unnoticed by the person.

Complications of diphtheria:

These are some of the rare complications that may occur if the disease is left untreated.

·        Difficult breathing or suffocation due to the blockages in the airway

·        Heart failure, Myocarditis

·        Kidney failure

·        Damage to the nerves

·        Death

Causes of Diphtheria:

The main causative agent is a species of bacteria called corynebacterium diphtheria; the disease symptoms are mostly due to the toxins produced by them.

Modes of Transmission:

•  Respiratory diphtheria spreads via the airborne transmission.

A person infected with diphtheria, when sneezes, speaks, coughs or breaths, he or she may expel out the micro-droplets containing the bacteria into the air. When such infected air is inhaled by a healthy person, he or she may get infected and within a week may start developing symptoms of respiratory diphtheria.

It still depends on the vaccination status of the person and his body’s immunity. The persons/children unvaccinated are at more risk of getting infected with the disease.

• The cutaneous diphtheria spreads through contact with the infected skin lesions.

Diagnosis of diphtheria:

Ø Physical assessment of the patient

Ø Traveller’s history

Ø Immunisation status

Ø Laboratory tests for nasal or throat swabs and skin lesions

Ø Complete blood count test

Treatment of diphtheria

The treatment of diphtheria includes:

• v Isolation of the patient
• v Treatment with antibiotic medications
• v Complete bed rest
• v Adequate ventilation
• v Control of infection spread
• v Assessing the vital signs
• v Monitoring the breathing of the patient
• v Assessing for major organ functions to detect early complications

Recovery from diphtheria may take up to one to one and half months before the symptoms usually subside completely. The milder cases usually recover within few weeks. The severe cases require more attention so as to avoid any possible fatal complications and death.

Prevention of Diphtheria:

v Vaccination is the most effective prevention strategy for diphtheria. It has been included in the national immunization schedule globally to help prevent the children from diphtheria. 

v The vaccine is mostly available as a trivalent combination(DPT)including protection against diphtheria, pertussis(whooping cough), and tetanus. Three main doses are given at 1 ½ , 2 ½ and 3 ½  months followed by the booster doses at the age of 15 or 18 months. The next booster is five years of age and the last is give during the adolescent period almost after 10 years of the previous shot. (The vaccination schedule may vary in different countries. This is only for general information.)

v Due to the widespread vaccination, the number of cases are remarkably low in the world.

Other preventive measures include:

 ·        Hygienic conditions: practise regular and strict hand washing. For the persons who are taking care of the sick people or children, hand washing and covering their faces using the face masks is inevitable to prevent contracting the infection to them.

·        Emphasizing on the sanitation facilities

·        Health education to prevent the spread of the infection

·        Vaccine shots prior to any travel

·        Healthy diet helps boost body’s natural defence system

Note: This blog post is for educational and informational purpose only. It is not a substitute for any medical advice, consultation or treatment. Please see your doctor in any case.