Diphtheria

Overview

Diphtheria is a highly contagious and potentially deadly disease of the upper respiratory tract. Fortunately for North Americans widespread vaccinations of school children have largely eradicated this once common illness. It is however still prevalent in many under developed nations.

Symptoms

The disease develops gradually over a period of 2 to 5 days. Early symptoms may be similar to those of a common cold with a sore throat mild fever and chills. Other symptoms may include:

  • fatigue
  • difficulty swallowing
  • listlessness
  • pallor
  • fast heart rate
  • drooling (suggests airway obstruction is about to occur)
  • bloody watery drainage from nose
  • croup-like (barking) cough
  • difficulty breathing or rapid breathing
  • absent breathing (apnea) 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)
  • thick grey membrane covering the tonsils throat or the inside of the nose (sometimes)

Complications:

  • in 10% of cases patients experience neck swelling which brings a higher risk of death
  • low blood pressure
  • cardiomyopathy
  • peripheral neuropathy

Cause

Diphtheria is caused by a bacterium Corynebacterium diphtheriae. The actual disease is triggered when the bacteria release a toxin into the body of an infected person.

Diphtheria is typically transmitted when an infected person coughs or sneezes which sends the potentially deadly bacteria into the air where others can breathe it in. It can also be transmitted by contaminated objects or foods (especially contaminated milk). The bacteria primarily infect the nose and throat but they may also infect the skin producing lesions. It can also spread via the bloodstream to other organs. The heart and nervous system are most frequently and most severely affected.

Risk factors include crowding poor hygiene lack of childhood immunization and a failure to give booster shots to adults. Because the vaccine wears off as we age it is recommended that adults get a booster shot to ensure that they are still protected. This is especially important for those who travel to parts of the world where outbreaks still occur particularly areas that have crowded conditions with poor sanitation.

Treatment

As soon as diphtheria is suspected doctors will administer an antitoxin. Then if the disease is confirmed antibiotics are used to eradicate the bacteria. Patients with severe symptoms will typically be hospitalised in an intensive care unit for more specialized treatment.