And we must know about the symptoms, prevention, and the way of treatment so that Children avoid Diphtheria disease that will happen to anyone including the family members we care about.
Definition of Diphtheria Disease
Diphtheria is a throat and nasal infection caused by a toxin produced by Corynebacterium diphtheriae bacteria. Which can affect adults and children.
Diphtheria is a rare disease since its introduction in Australia, vaccine prevention will be more effective in reducing the risk of diphtheria in your boys.
But a century ago, was the most common cause of infectious death. Outbreaks still occur in countries where vaccination rates are very low.
How to Distribute Diphtheria
People can carry diphtheria bacteria harmlessly in the nose and throat ('Carrier'). Diphtheria bacteria spread when an infected person (patient or carrier) speaks, coughs or sneezes tiny droplets containing infectious agents into the air.
Drops in the air can be inhaled by the people closest to you. Diphtheria bacteria are also spread by indirect contact with hands, tissues or other articles that are dirty by the discharge of the nose and throat, or by indirect contact with skin injuries.
Facts About Diphtheria
Diphtheria is a contagious disease caused by bacteria that usually produce exotoxins that damage human tissue.
Early symptoms of flu-like diphtheria but worsen include fever, swallowing problems, hoarseness, enlarged lymph nodes, cough, and shortness of breath; some patients may have skin involvement, producing skin ulcers.
The history of diphtheria comes from Hippocrates; Once organisms are identified and found to produce exotoxins, vaccine development has significantly reduced diphtheria worldwide.
The cause of diphtheria is infection by Corynebacterium species; The most severe infections are caused by Corynebacterium strains that produce exotoxins.
The highest risk factor for developing diphtheria does not get immunization against this disease; Other factors include crowding, immunosuppression, and direct or indirect contact with infected individuals.
Diphtheria is diagnosed with patient history and physical examination; The Corynebacterium culture of the patient produces a definite diagnosis although the patient should be treated if diphtheria is even suspected.
Treatment of diphtheria involves early antibiotics; The use of antitoxin, made on horses, is done to neutralize Corynebacterium exotoxins that are not yet attached to human tissues.
Diphtheria complications include problems of heart rhythm, sepsis, organ damage, and respiratory problems that can be severe enough to cause death.
If treated appropriately and early in the infection, the prognosis in diphtheria is usually good; However, if complications develop, the prognosis decreases, especially if sepsis and / or cardiac involvement are present.
It is possible to prevent diphtheria; The main way is to properly vaccinate individuals with one of the four major vaccine types present.
The best way to prevent diphtheria is to get vaccinated. In the United States, there are four vaccines used to prevent diphtheria: DTaP, Tdap, DT, and Td. Each of these vaccines prevent diphtheria and tetanus; DTaP and Tdap also help prevent pertussis (whooping cough).
DTaP and DT are given to children under the age of seven, while Tdap and Td are given to older children, adolescents and adults.
What is Diphtheria?
Diphtheria is an infectious disease caused by Corynebacterium bacterial species and is most commonly associated with throat pain, fever, and membrane development that adhere to the tonsils and / or nasopharynx.
Severe infection can affect other organ systems such as the heart and nervous system. In addition, some patients with diphtheria may also develop skin infections. Exotoxin produced by bacteria is an important component in causing more severe diphtheria symptoms.
Symptoms and Signs of Diphtheria?
Initially the symptoms of diphtheria may be similar to upper respiratory tract infections but symptoms worsen about two to five days. Symptoms may include:
- Headache
- Sore throat
- Hard to breath
- Hoarseness
- Cough
- Fever
- Difficulty Swallowing Food
- Easy Weak
- Enlarged Lymph Nodes (Mumps)
As the disease progresses, the obedient membrane (pseudomembrane) may begin to include tonsillitis of tonsils, pharynx, and / or nasal. If left untreated, pseudomembranes may extend into the larynx and trachea and block the airway; This can lead to death.
The symptoms of skin diphtheria include early, painful redness lesions that can develop into nonhealing ulcers. Some boils can be covered by a gray membrane.
The History of Diphtheria?
Diphtheria has infected humans for centuries. Hippocrates produced the first documented description of diphtheria in the fifth century BC. This disease has been a leader in causing death, especially in children, for centuries.
Bacteria were first identified in the 1880s by F. Loffler. In the 1890s, exotoxins were discovered. The first diphtheria toxoid vaccine was produced in the 1920s.
Vaccination programs have decreased the incidence of diphtheria worldwide, however, when the vaccination rate goes down, the rate of diphtheria infection increases and, occasionally, a serious disease outbreak occurs.
For example, in the 1990s, the epidemic in Russia caused about 5,000 deaths according to World Health Organization statistics (WHO), and from about 1993-2003, Latvia reported 101 deaths due to diphtheria.
Before diphtheria vaccination program, there are 100,000 to 200,000 cases of diphtheria each year in the U.S., which causes about 15,000 to 20,000 deaths. According to the CDC, fewer than five cases have been reported in the U.S. in the last 10 years.
What Causes Diphtheria?
The cause of diphtheria is a bacterial species called Corynebacterium diphtheriae, a gram-positive bacterium that usually produces exotoxins. There are four main strains (biotype) C. diphtheriae: gravis, intermedius, myitis, and belfanti.
Strains called intermedius are most often associated with exotoxin production although these three strains are capable of producing exotoxins.
The organisms easily attack the tissues lining the throat, and during the invasion, they produce exotoxins that destroy tissue and cause the development of pseudomembrane.
Non-toxin-producing species and other Corynebacterium species such as C. ulcerans can still cause infection, but the infection is less severe and occasionally persists in the skin (skin infection).
Diphtheria Risk Factors?
Since human carriers or symptomatic individuals are the main reservoirs for infection, situations such as population density (dormitories, institutional housing, poor living conditions), incomplete immunizations, and people with impaired immunity are at higher risk of diphtheria.
Diphtheria is transmitted by air droplet inhalation or by direct contact with patients infected with mucosal secretions or skin ulcerations.
Some people may carry bacteria to the respiratory tract but do not show the illness. However, such individuals can still transmit organisms to uninfected individuals.
How Do Doctors Diagnose Diphtheria?
The initial diagnosis of diphtheria is usually done from patient history and physical examination and presence of pseudomembrane formation in the throat.
Confirmation is based on the isolation of organisms from swab specimens taken from the throat or from skin lesions. However, since diphtheria can be lethal, the CDC recommends immediate treatment if diphtheria is suspected; do not wait for laboratory confirmation.
What is the Treatment for Diphtheria?
There are two treatment strategies used for patients diagnosed with diphtheria. Both are most effective when used early in the disease process. The first treatment is antibiotics.
The CDC recommends erythromycin as first-line therapy for patients over 6 months of age. For younger patients or those unable to receive erythromycin, the CDC recommends intramuscular penicillin.
Patients usually do not get an infection after about 48 hours of antibiotic treatment and should be isolated until then to prevent the spread of the disease.
The second treatment is the administration of diphtheria antitoxin. However, this antitoxin is only available from the CDC. Diphtheria antitoxin reduces the progression of this disease by binding to diphtheria diphtheria that has not been attached to body cells.
Antitoxin comes from horses, so recipients should not be treated if they are allergic. Your doctor will make a decision if you only need antibiotics or antibiotics plus antitoxin based on your symptoms, immunization status, and disease progression.
What Are the Possible Complications of Diphtheria?
The worst complication of diphtheria is respiratory failure or death from pseudomembrane formation that inhibits the airway.
Other possible complications include heart problems such as rhythm disturbances, myocarditis, heart block, secondary pneumonia, septic shock, and other organ infections such as the spleen, central nervous system, or cardiac tissue.
What is the Prognosis of Diphtheria?
The prognosis of diphtheria ranges from good to poor, depending on how early the infection is treated by the patient, and how the patient responds to treatment.
If the patient develops sepsis or bacteremia, or if there is cardiac involvement, the prognosis is usually poor.
The highest mortality rate (death) in patients aged less than 5 years and in patients aged over 40 years. The average mortality rate is about 5% -10%.
Is it possible to prevent diphtheria? Is there a diphtheria vaccine?
It is possible to prevent diphtheria; the most effective way is to vaccinate your Children early in their life and to prevent infected people from connecting with uninfected people.
In addition, individuals who carry bacteria can be treated with antibiotics to remove bacteria and thus reduce the possibility of carriers transmitting bacteria to others.
There are vaccines available to protect individuals from diphtheria and all formulations contain toxoid concentrations that stimulate the production of antibodies against diphtheria toxin (D or d).
This toxoid vaccination may also contain asylular pertussis vaccine (aP or ap) and tetanus (T). They are as follows: DTaP, Tdap, DT, and Td. DTaP is a childhood vaccine while Tdap is an adult vaccine.
Perhaps the most important vaccine is DTaP, given at 2 months, 4 months, 6 months, 15-18 months, and 4-6 years.
DT does not contain pertussis and is given to children who have responded to pertussis vaccine; Td is a vaccine for teens and adults given every 10 years as a booster for tetanus.
Tdap has several formulations; CDC in 2012 recommends that Tdap formulation be used as an amplifier to cover pertussis, not just Td formulations against tetanus and diphtheria alone.
Side effects of this vaccine are usually mild like pain or tenderness at the injection site and / or low-grade fever. This effect is usually lost within a day. However, some patients experience more severe symptoms.
Although this is rare, patients who do so should be aware of their reactions and tell the medical caregiver that they may have allergies (eg allergies to tetanus or pertussis vaccines).
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