Diphtheria

Diphtheria is a serious bacterial illness that often starts in the lining of the nose and throat. It's very uncommon in places like the United States and other developed countries because most people there get a vaccine that protects against it. However, in countries with less access to healthcare and vaccines, diphtheria is still a problem and happens more often.

Diphtheria can be treated with medicine. But if it gets bad, it can harm the heart, kidneys, and nervous system. Even with treatment, diphtheria can be fatal, particularly in young children. This is because the body's systems can struggle to fight off the infection and the damage it causes.

Diphtheria symptoms typically appear 2 to 5 days after infection. These symptoms can include:

• A thick, grayish coating on the throat and tonsils: This coating can make swallowing difficult.
• Sore throat and a raspy voice (hoarseness): This is a common early symptom.
• Swollen lymph nodes (glands) in the neck: These swollen areas are often tender to the touch.
• Trouble breathing or breathing faster than usual: This is a serious symptom requiring immediate medical attention.
• Runny nose: A nasal discharge is another possible sign.
• Fever and chills: These are common signs of infection.
• Feeling very tired: Fatigue is a frequent symptom of the illness.

Sometimes, people infected with diphtheria bacteria experience only very mild symptoms, or none at all. These people are called "carriers." They can spread the disease to others even though they don't show any noticeable signs of illness themselves. This means a carrier can unknowingly pass on the infection.

If you or your child has been near someone who might have diphtheria, call your doctor right away. Diphtheria is a serious illness. If you're unsure if your child has received all the recommended diphtheria vaccinations, please contact your doctor to schedule an appointment. It's also a good idea to make sure you yourself are up-to-date on your diphtheria vaccinations.

Diphtheria is an illness caused by a germ called Corynebacterium diphtheriae. This germ usually grows on or close to the surface of your throat or skin. It spreads in a few ways:

• Through the air: When someone with diphtheria coughs or sneezes, they release tiny droplets of moisture containing the germ. If someone nearby breathes in these droplets, they can get infected. This is why diphtheria can spread quickly in places where many people are close together, like schools or crowded apartments.

• Through contact with contaminated objects: If you touch something that's been touched by someone with diphtheria, like a used tissue or a towel, you could pick up the germ. If an infected person has an open wound, touching it can also spread the bacteria.

• From an infected person without symptoms: Someone infected with diphtheria, even if they don't seem sick, can still spread the bacteria to others who haven't been vaccinated against diphtheria. This means that even people who haven't shown any signs of the illness can pass it on to others.

It's important to remember that getting the diphtheria vaccine is a good way to protect yourself and others from this illness.

Diphtheria is a disease that's less common in the US and Western Europe, thanks to widespread childhood vaccinations. But it's still a problem in many parts of the world. Who's most likely to get it?

• People without up-to-date shots: If you haven't gotten your diphtheria vaccinations, you're more vulnerable. This includes both children and adults. Keeping your shots current is important for protecting yourself and others.

• People in crowded or unsanitary places: Living in close quarters where hygiene is a concern can increase the risk of catching germs like diphtheria. This is because germs can spread more easily in these environments.

• People who travel to places with higher diphtheria rates: If you travel to a country where diphtheria is more common, you're more likely to be exposed to the bacteria. This is true even if you've been vaccinated, as travel exposes you to more potential sources of the infection.

In places where most people are vaccinated, like the US and Western Europe, diphtheria is mainly a concern for people who aren't fully vaccinated or haven't had the recommended booster shots. This often happens when they travel internationally or come into contact with someone from a country where vaccinations aren't as widespread. It's important to remember that even in areas with high vaccination rates, getting your shots is crucial for your personal protection and to help prevent the spread of the disease.

Diphtheria, if left untreated, can cause serious problems:

• Trouble breathing: The bacteria that cause diphtheria release a harmful substance (toxin). This toxin damages the tissues around the infection site, usually the nose and throat. The damaged area forms a thick, gray coating (membrane) made of dead cells, bacteria, and other materials. This coating can block the airways, making breathing difficult.

• Heart problems: The diphtheria toxin can spread throughout the body through the bloodstream, damaging other tissues, including the heart muscle. This damage, called myocarditis, can cause inflammation of the heart muscle. The inflammation might be mild or severe. In severe cases, myocarditis can lead to heart failure, which can be life-threatening, and even sudden death.

• Nerve damage: The toxin can also harm the nerves. This can affect nerves in the throat, making it hard to swallow. Nerve damage can also cause inflammation and weakness in the muscles of the arms and legs. If the nerves controlling breathing muscles are damaged, those muscles can become paralyzed. If this happens, you may need a machine to help you breathe.

Treatment for diphtheria usually helps people recover, but getting better can take a long time. Unfortunately, diphtheria is deadly in about 5% to 10% of cases. Young children under 5 and adults over 40 are more likely to die from diphtheria.

Diphtheria was a common childhood illness before the invention of antibiotics. Now, it's both treatable and preventable thanks to a vaccine.

This vaccine is often given together with shots for tetanus and whooping cough (pertussis). This combined vaccine is called the diphtheria, tetanus, and pertussis vaccine, or DTaP. A slightly different version of this vaccine for older teens and adults is called Tdap.

Doctors in the US strongly recommend the DTaP vaccine for babies. It's given in a series of five shots, usually in the arm or leg, at these ages:

• 2 months
• 4 months
• 6 months
• 15-18 months
• 4-6 years

The DTaP vaccine is very good at preventing diphtheria. But, like any medicine, it can cause some side effects. Some babies might have a mild fever, be a bit fussy, or feel sleepy after the shot. They might also have a sore spot where the shot was given. Talk to your doctor about ways to help your child feel better.

Serious side effects are rare. Occasionally, a very small number of children have a serious but treatable reaction to the DTaP vaccine, such as an allergic reaction (like hives or a rash) that appears within minutes.

Some children, like those with epilepsy or other nervous system problems, may not be able to get the DTaP vaccine. If you have any concerns, talk to your doctor.

A doctor might think a child has diphtheria if they have a sore throat and a gray coating on their tonsils and throat. To be sure, a sample of this coating is sent to a lab. If the lab finds a specific type of bacteria (called C. diphtheriae) in the sample, that confirms the diagnosis. Doctors can also test a skin wound for diphtheria bacteria if they think it might be a case of skin diphtheria.

Even before the lab results come back, treatment for diphtheria starts right away. It's important to start treatment quickly because diphtheria can be serious.

Diphtheria is a serious illness that needs immediate and strong medical attention. Doctors' first priority is making sure the person's breathing isn't blocked. This might involve inserting a tube into the throat to keep the airway open until the swelling goes down.

Several treatments are used for diphtheria:

Antitoxin: If a doctor suspects diphtheria, they'll ask for a special medicine called an antitoxin. This medicine works to neutralize the harmful effects of the diphtheria toxin in the body. The antitoxin is produced and supplied by the Centers for Disease Control and Prevention (CDC). It's injected into a vein or muscle.

Before giving the antitoxin, doctors usually do a skin test to check for allergies. This is to make sure the person won't have a bad reaction to the medicine. If an allergy is found, the doctor will likely advise against giving the antitoxin.

Hospitalization: Both children and adults with diphtheria often need to stay in the hospital for treatment. They might be placed in an intensive care unit (ICU). This is because diphtheria can spread easily to people who haven't been vaccinated.

Preventing Spread: If you've been near someone with diphtheria, see a doctor right away. They may do tests and prescribe antibiotics to help prevent you from getting sick. You might also need a booster shot of the diphtheria vaccine.

Treating Carriers: People who carry the diphtheria bacteria in their bodies are also treated with antibiotics. This treatment helps clear the bacteria from their system.

Antibiotics: Antibiotics, such as penicillin or erythromycin, are used to kill the bacteria causing diphtheria. Using antibiotics reduces how long a person with diphtheria is contagious. They help clear up the infection more quickly.

Important Note: The antitoxin is crucial for neutralizing the toxin produced by the bacteria. The antibiotics target the bacteria themselves, helping to stop the infection and reduce the spread. Both treatments work together to effectively manage diphtheria.

Getting better from diphtheria means lots of rest. If your heart is affected, avoiding any strenuous activity is crucial. You might need to eat mostly liquids and soft foods for a time because swallowing might be painful or difficult.

To stop the infection from spreading, it's important to stay separate from others while you're contagious. Everyone in your home should wash their hands very carefully to help prevent the spread.

After you recover, you'll need a complete series of diphtheria shots. Unlike some other illnesses, having diphtheria doesn't automatically mean you'll never get it again. If you aren't fully vaccinated, you could get diphtheria more than once.