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Information on Diphtheria
What is diphtheria?
Diphtheria is an acute infectious disease caused by the toxin-producing bacteria Corynebacterium diphtheriae.
How do you get it?
Diphtheria is usually transmitted by close contact with an infected person or asymptomatic (someone who does not appear to be sick) carrier. It can also be transmitted by contaminated objects or foods (such as contaminated milk).
How long after exposure to the disease will I get sick?
People generally develop symptoms after being exposed in 2 to 5 days.
The bacteria primarily infect the nose and throat, although they may initially infect the skin, producing skin lesions. Corynebacterium diphtheriae produces a toxin that causes tissue damage (necrosis) in the immediate area of the infection, usually the nose and throat.
It can also spread via the bloodstream to other organs, where it can cause significant damage. Although the toxin can damage any tissue, the heart and nervous system are most frequently and most severely affected.
Localized infection in the throat and tonsillar area produces a characteristic membrane that is gray to black, tough, and fibrous. This membrane can cause airway obstruction.
Diphtheria may be mild and unrecognized or it may become progressive. If toxin enters the bloodstream, the patient may develop inflammation of the heart muscle (myocarditis), which is the most common and most worrisome complication. Toxic effects on the nervous system may also cause temporary paralysis.
The disease is now rare in many parts of the world because of widespread immunization. Risk factors include crowding, poor hygiene, and lack of immunization. The incidence of diphtheria in the U.S. is fewer than 5 cases per year. In 1993 and 1994, the states of the former USSR experienced a diphtheria epidemic, with more than 150,000 reported cases and 5,000 deaths. The epidemic was related to a drop in routine childhood DPT immunization to less than 60% of the population, failure to give booster doses to adults, and worsening economic conditions in the affected countries.
What are the symptoms?
- Sore throat (may range from mild to severe with painful swallowing and hoarseness)
- Drooling (suggests airway obstruction is about to occur)
- Fever and chills
- Bloody, watery drainage from nose
- Croup-like (barking) cough
- Difficulty breathing, or rapid breathing
- Absent breathing may occur
- Bluish coloration of the skin may be caused by lack of oxygen
- Skin lesions can be seen in cutaneous diphtheria (usually seen in the tropics)
Note: There may be no symptoms.
How is diphtheria treated?
Diphtheria antitoxin is given by injection as soon as the diagnosis is suspected. The infection is then treated with antibiotics, such as penicillin or erythromycin.
People with diphtheria may require hospitalization for supportive treatment and during the administration of antitoxin.
Is diphtheria serious?
Yes, diphtheria is serious. The death rate is 10% (10 in 100 cases are fatal). Recovery from the illness is slow; therefore, activities must be resumed slowly.
The diphtheria toxin can damage the heart, nervous system, kidneys, or other organs resulting in disorders such as:
- Myocarditis which can lead to heart failure.
- Severe nerve damage that can cause paralysis.
- Kidney damage.
How can I prevent diphtheria?
Routine childhood immunizations and adult boosters prevent the disease.
Source: Medline Plus, June 29, 2006
