DIPHTHERIA

INTRODUCTION
 Diphtheria is a serious bacterial infection that usually affects the

mucous membranes of your nose and throat. Diphtheria is

extremely rare in the United States and other developed countries,
thanks to widespread vaccination against the disease.
 Diphtheria can be treated with medications. But in advanced stages,

diphtheria can damage your heart, kidneys and nervous system.

Even with treatment, diphtheria can be deadly, especially in
children.
SYMPTOMS
Diphtheria signs and symptoms usually begin two to five days after a
person becomes infected. Signs and symptoms may include:
 A thick, gray membrane covering your throat and tonsils
 A sore throat and hoarseness
 Swollen glands (enlarged lymph nodes) in your neck
 Difficulty breathing or rapid breathing
 Nasal discharge
 Fever and chills
 Tiredness
 In some people, infection with diphtheria-causing bacteria causes

only a mild illness — or no obvious signs and symptoms at all.

Infected people who stay unaware of their illness are known as
carriers of diphtheria
SKIN (CUTANEOUS)
DIPHTHERIA
 A second type of diphtheria can affect the skin, causing pain,
redness and swelling similar to other bacterial skin infections.
Ulcers covered by a gray membrane also may be skin diphtheria.
 Although it's more common in tropical climates, diphtheria on the
skin also occurs in the United States. It may happen especially
among people with poor hygiene who live in crowded conditions.
CAUSES
Diphtheria is caused by the bacterium Corynebacterium diphtheriae.
The bacterium usually multiplies on or near the surface of the throat
or skin. C. diphtheriae spreads through:
 Airborne droplets. When an infected person's sneeze or cough
releases a mist of contaminated droplets, people nearby may inhale
C. diphtheriae. Diphtheria spreads easily this way, especially in
crowded conditions.
 Contaminated personal or household items. People sometimes catch
diphtheria from handling an infected person's things, such as used
tissues or hand towels, that may be contaminated with the bacteria.
 You can also transfer diphtheria-causing bacteria by touching an
infected wound.
RISK FACTORS
People who are at increased risk of catching diphtheria include:
 Children and adults who don't have up-to-date vaccinations
 People living in crowded or unsanitary conditions
 Anyone who travels to an area where diphtheria infections are more
common
COMPLICATIONS
If left untreated, diphtheria can lead to:
 Breathing problems. Diphtheria-causing bacteria may produce a
toxin. This toxin damages tissue in the immediate area of infection
— usually, the nose and throat. At that site, the infection produces a
tough, gray-colored membrane made up of dead cells, bacteria and
other substances. This membrane can obstruct breathing.
 Heart damage. The diphtheria toxin may spread through your bloodstream and
damage other tissues in your body. For example, it can damage your heart
muscle, causing such complications as inflammation of the heart muscle
(myocarditis). Heart damage from myocarditis may be slight or severe. At its
worst, myocarditis can lead to heart failure and sudden death.
 Nerve damage. The toxin can also cause nerve damage. Typical targets are
nerves to the throat, where poor nerve conduction may cause difficulty
swallowing. Nerves to the arms and legs also may become inflamed, causing
muscle weakness.
 If the diphtheria toxin damages the nerves that help control muscles
used in breathing, these muscles may become paralyzed. At that
point, you might need mechanical assistance to breathe.
 With treatment, most people with diphtheria survive these
complications, but recovery is often slow. Diphtheria is fatal about
5% to 10% of the time. Rates of death are higher in children under
age 5 or adults older than age 40.
PREVENTION
 Before antibiotics were available, diphtheria was a common illness
in young children. Today, the disease is not only treatable but also
preventable with a vaccine.
 The diphtheria vaccine is usually combined with vaccines for
tetanus and whooping cough (pertussis). The three-in-one vaccine
is known as the diphtheria, tetanus and pertussis vaccine. The latest
version of this vaccine is known as the DTaP vaccine for children
and the Tdap vaccine for adolescents and adults.
vaccination consists of a series of five shots, typically administered
in the arm or thigh, given to children at these ages:
 2 months
 4 months
 6 months
 15 to 18 months
 4 to 6 years
BOOSTER SHOTS
 After the initial series of immunizations in childhood, you need booster shots
of the diphtheria vaccine to help you maintain your immunity. That's because
immunity to diphtheria fades with time.
 Children who received all of the recommended immunizations before age 7
should receive their first booster shot at around age 11 or 12. The next booster
shot is recommended 10 years later, then repeated at 10-year intervals. Booster
shots are particularly important if you travel to an area where diphtheria is
common.
DIAGNOSIS
 Doctors may suspect diphtheria in a sick child who has a sore throat
with a gray membrane covering the tonsils and throat. Growth of C.
diphtheriae in a lab culture of material from the throat membrane
pins down the diagnosis. Doctors can also take a tissue sample from
an infected wound and have it tested in a lab to check for the type
of diphtheria that affects the skin (cutaneous diphtheria).
TREATMENT
 Diphtheria is a serious illness. Doctors treat it immediately and
aggressively. Doctors first ensure the airway isn't blocked or
reduced. In some cases, they may need to place a breathing tube in
the throat to keep the airway open until the airway is less inflamed.
 Treatments include:

Antibiotics. Antibiotics, such as penicillin or erythromycin, help kill

bacteria in the body, clearing up infections. Antibiotics cut the time
that someone with diphtheria is contagious.
An antitoxin. If a doctor suspects diphtheria, he or she will request a
medication that counteracts the diphtheria toxin in the body from the
Centers for Disease Control and Prevention. Called an antitoxin, this
drug is injected into a vein or muscle.