Diphtheria

Written by Carmella Wint | Published on July 25, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

Overview

Diphtheria is a bacterial infection that affects the membranes of the throat and nose. Although it spreads easily, diphtheria can be prevented through the use of vaccines. If left untreated, diphtheria can cause severe damage to your kidneys, nervous system, and heart. According to the Mayo Clinic, diphtheria is fatal in about 10 percent of cases. (Mayo)

What Causes Diphtheria?

Diphtheria is caused by the corynebacterium diphtheriae bacterium. It’s most commonly spread through person-to-person contact or contact with items that have the bacteria on them. Coming into contact with items such as an infected person’s cup or used tissue can transfer the bacteria. The mist exhaled by an infected person’s sneeze or cough can also contain the bacteria.

Even if the infected person does not show any signs or symptoms of diphtheria, he or she is still able to transmit the infection for up to six weeks.

Am I At Risk?

Children in the United States are routinely vaccinated against diphtheria. You are usually only at risk if you visit a country that does not provide immunizations or if you’re not up to date on your vaccinations. According to the World Health Organization, India and Indonesia had the highest number of diphtheria incidents in 2011. (WHO)

Before the use of vaccines, children had the highest risk of being infected. Now, people with a weakened immune system—such as those with AIDS—are included in the at-risk group. Unclean living conditions have also been linked to an increased risk of infection.

Preventing Diphtheria

With the use of antibiotics and vaccines, diphtheria is not only treatable, but preventable as well.

The vaccine for diphtheria is given in a single shot (along with vaccines for pertussis and tetanus) that is called DTaP. The DTaP vaccine is administered in a series at 2, 4, and 6 months of age, and then again at around 1 and 4 years of age. In rare cases, a child might have an allergic reaction to the vaccine. This can result in seizures or hives that later go away.

Because vaccines last for only 10 years, you’ll want to have your child vaccinated again around the age of 12 to maintain diphtheria protection. For adults, it’s recommended that you get a combined diphtheria and tetanus booster called the Td vaccine to maintain your protection.

Recognizing the Signs of Diphtheria

Signs of diphtheria often appear two to five days after infection. In some cases, you could be a carrier of C. diphtheriae and have only mild symptoms (that are similar to the common cold) or no symptoms at all. The most common and visible symptom is a thick, gray coating on your throat and tonsils. Other common symptoms include:

  • difficulty breathing
  • swollen lymph nodes in the neck
  • chills
  • fever
  • a loud, barking cough
  • bluish skin
  • a sore throat
  • drooling
  • a general feeling of uneasiness or discomfort

If you have poor hygiene or live in a tropical area, you may develop cutaneous diphtheria, or diphtheria of the skin. Diphtheria of the skin usually presents as redness in the affected area and ulcers that may be covered with a gray membrane like the one found in the throat.

Diagnosing Diphtheria

Your doctor will likely perform a physical exam to check for swollen lymph nodes. He or she will also ask you about your medical history and the symptoms you’ve been having.

Your doctor may believe that you or your child has diphtheria after observing a gray coating in the throat. A throat culture may be taken to provide a definitive diagnosis. If your doctor suspects diphtheria of the skin, a sample of the affected tissue may be removed and sent to a lab for testing.

Treatment for Diphtheria

Because diphtheria is a serious illness, your doctor will likely want to treat you quickly and aggressively. The first step is an antitoxin injection. If you’re allergic to the antitoxin (previous allergic reactions to diphtheria immunizations or any drug preparations containing horse products), inform your doctor and he can give you small doses of the antitoxin and gradually build up to higher amounts.

After the diphtheria antitoxin, your doctor will prescribe antibiotics like erythromycin and penicillin. Antibiotics help clear up the infection. During treatment, your doctor may have you stay in the hospital to avoid passing on your infection. People you might have exposed to the C. diphtheriae bacteria will want to receive a booster vaccine or antibiotics.

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