DIPHTHERIA

Diphtheria is caused by the bacterium Corynebacterium diphtheria. This germ produces a toxin that can harm or destroy human body and organs. One type of diphtheria affects the throat and sometimes the tonsils. Another type which is more common in the tropics causes ulcers on the skin.

Diphtheria affects people of all ages, but most often it strikes unimmunized children. In temperate climates, diphtheria tends to occur during the older months. In 2000, 10000 cases and 3000 deaths of diphtheria were reported worldwide.

HOW IS DIPHTHERIA SPREAD

Diphtheria is transmitted from person to person through close physical and respiratory contact. It can cause infection of the naso-pharynx, which may lead to breathing difficulties and deaths.

SIGN AND SYMPTOMS

When diphtheria affects the throat and tonsils, the early symptoms are sore throat, loss of appetite, and slight fever. Within two to three days a bluish-white or grey membrane forms in the throat and on the tonsils. This membrane sticks to the palate of the throat and may bleed. If there is bleeding, the membranes may become greyish-green or black. The patient may either recover at this point or develop severe weakness and die within six to ten days. Patients with severe diphtheria do not develop a high fever but may develop a swollen neck and obstructed airway.

COMPLICATION

During the early phase of the illness or even weeks later, patients may develop abnormal heartbeats, which can results in heart failure. Some patients with diphtheria experience inflammation of the heart muscle and valves, leading after many years to chronic heart disease and heart failure. The most severe complication of diphtheria is respiratory obstruction followed by death.

TREATMENT

Children who develop diphtheria should be given diphtheria antitoxin and antibiotics, such as erythromycin or penicillin. They should be isolated to avoid exposing others to the disease. About two days after starting antibiotic treatment patient are no longer infectious.

For confirmation of diagnosis, health workers should obtain throat cultures from suspected cases. However, treatment should begin without waiting for cultures results.

PREVENTION

The most effective way of preventing diphtheria is to maintain high level of immunization in the community. In most countries, diphtheria toxoids vaccine is given in combination with tetanus toxoids and Pertussis vaccine (DPT). Most recently, some countries have been using a combination vaccine that includes vaccine for diphtheria, tetanus, Pertussis, hepatitis B (hepB), and sometimes Haemophilis influenza type b (Hib). Approximately every ten years, booster doses of the adult form of the vaccine, tetanus, diphtheria toxoids vaccine, may be needed to maintain immunity.