Contents
- What is diphtheria?
- What is the cause of diphtheria?
- What are the symptoms of diphtheria?
- How is laryngeal diphtheria manifested?
- What is nasal diphtheria manifested?
- How to proceed in case of illness?
- How is diphtheria diagnosed?
- What are the complications of diphtheria?
- How is diphtheria treated?
- What should I do after the end of treatment?
- How can diphtheria be prevented?
- What should I know about the diphtheria vaccine?
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Diphtheria is a disease caused by bacteria. Infection usually occurs through droplets. It is possible through contacts with a sick person or with infected objects. The disease is not free from complications that can even lead to the patient’s death. Diphtheria vaccination is a form of protection against the disease.
Diphtheria is a serious disease that can be protected against by immunization. Four doses are included in the immunization program. What are diphtheria vaccinations like? When should I give my child the next doses?
What is diphtheria?
Diphtheria is an acute, infectious disease. It is caused by gram-positive bacteria, coryneform diphtheria. Infection with bacteria occurs via droplets. It can be infected both from a sick person and from a person who has had diphtheria and from the carrier of the bacterium itself.
The bacterium enters the body through the nasal or oral cavity, and then inhabits the mucous membranes of the upper respiratory tract. The mucosa of other areas or the skin is colonized much less frequently. Therefore, the most common forms of the disease are pharyngeal or laryngeal diphtheria, i.e. croup. Diphtheria is less likely to affect the conjunctiva, middle ear, genital mucosa or skin wounds.
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The bacteria secretes a toxin that passes through damaged tissue into the bloodstream. As a consequence, it can damage internal organs such as the kidneys, adrenal glands, heart, liver and central nervous system.
The use of diphtheria vaccines has significantly reduced the number of cases. Today, more than 85% of the world’s population is vaccinated.
Check: Vaccinations in Poland – mandatory and recommended
What is the cause of diphtheria?
The cause of diphtheria is an infection with the coryneform bacteria. The symptoms of the disease are due to the toxin secreted by this strain of bacteria, so other types of bacteria rarely cause diphtheria. It is worth knowing, however, that viruses that code the toxin of other closely related coryneform bacteria can also lead to diphtheria infection. As a result, they can start producing diphtheria toxin and cause diphtheria. Therefore, it should be remembered that while the coryneform bacteria can be infected from humans, in the case of viruses they can also be transmitted by pets.
What are the symptoms of diphtheria?
The coryneform bacteria usually cause pharyngeal diphtheria. The symptoms of this infection are moderate fever, sore throat, paleness, difficulty swallowing, the so-called dumpling speech, a coating on the throat, and visibly enlarged and painful lymph nodes. The places where the raid has appeared are bloodshot, but they may bleed when the raid is torn off. The nodes are so enlarged that they change the appearance of the neck (proconsul neck / Nero neck).
Other symptoms are characteristic of intoxication of the body, and therefore toxemia. Rapid work and deaf heart tones appear. Heart failure may occur, and in extreme cases even paralysis of all muscles or death.
How is laryngeal diphtheria manifested?
Another name for diphtheria of the larynx is angina or croup. The disease usually appears in young children. Symptoms include narrowing of the glottis due to swelling and a coating of the vocal cords. These symptoms cause shortness of breath and a loud barking cough. In addition, there may be a hoarse noise and, over time, silence. Untreated diphtheria can suffocate your baby.
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What is nasal diphtheria manifested?
Nasal diphtheria is the mildest form of the disease. There are no symptoms of poisoning. The changes in the nasal mucosa are small and usually affect one side. The lesions may be accompanied by muco-bloody or purulent-bloody exudate and erosions in the nostrils and on the upper lip.
The disease is chronic and the disease may spread. It takes a long time to recover and heal.
How to proceed in case of illness?
Suspicion of diphtheria requires immediate medical attention. Treatment requires hospitalization. Today, in Poland, the disease occurs very rarely, but unvaccinated people are really at risk of falling ill if they leave for endemic regions. Pregnant women, people with immunodeficiency, HIV-infected and organ transplant patients should be especially careful about the infection.
How is diphtheria diagnosed?
The first suspicion of diphtheria can be made on the basis of the patient’s history. Infection may result from the lack of preventive vaccinations, stay in the area of endemic disease and contact with the sick person. The doctor also takes into account clinical symptoms, i.e. symptoms of toxemia, which means that the patient is in a serious condition without high temperature. To make a diagnosis, it is necessary to isolate the bacteria from a patient swab.
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What are the complications of diphtheria?
Diphtheria can take a different course. Nasal diphtheria has the slightest course. During it, no symptoms of poisoning appear, and apart from local lesions, it does not cause any complications.
In severe cases of the disease, diphtheria can lead to serious complications of the heart, nervous system or kidneys. Belong to them:
- airway obstruction;
- arrhythmias and heart failure;
- myocarditis;
- paralysis of the soft palate;
- paralysis of the muscles of the eyeball or diaphragm;
- secondary bacterial infections, e.g., otitis media, endocarditis, pneumonia;
- paralysis of the respiratory muscles leading to respiratory failure.
Mortality in diphtheria is around 5-10%, but it depends on the patient’s age. In children under 5 and people over 40, it can reach up to 40%. Untreated diphtheria is fatal in 50% of cases.
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How is diphtheria treated?
Treatment of diphtheria always requires hospitalization. In the hospital, the patient is given antitoxin, i.e. serum containing antibodies, as well as antibiotics. Time is of the essence in this disease, so if you suspect diphtheria, see your doctor as soon as possible. The timing of antitoxin administration often determines the effects of treatment.
Antibiotics administered during treatment are penicillin or erythromycin, which are of secondary importance. Treatment also requires rest, control and correction of water and electrolyte disturbances as well as coagulation. Symptomatic treatment is also necessary during the treatment of diphtheria, such as temperature control and painkillers.
If the disease is uneventful, symptoms disappear within a few days and recovery is complete. In the event of complications and, for example, damage to the heart muscle, it is a permanent consequence of diphtheria.
Treatment of laryngeal diphtheria often requires intubation or tracheotomy to prevent the patient from suffocation. Prolonged immobilization also requires venous prophylaxis to avoid thromboembolism and respiratory exercise. Breathing support is also often introduced.
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What should I do after the end of treatment?
After recovery, a sparing lifestyle is usually enough to quickly recover and recover. However, if there are complications, recovery may take much longer and require rehabilitation. However, it should be remembered that in such a situation there is no guarantee of full recovery.
How can diphtheria be prevented?
Diphtheria was the cause of frequent epidemics with a high percentage of deaths. That changed with the introduction of the diphtheria vaccine in 1954. There are no cases of diphtheria in Poland, but there are still cases of diphtheria worldwide.
Diphtheria is endemic in Southeast Asia, the South Pacific, the Middle East, Africa, Eastern Europe and Central America.
What should I know about the diphtheria vaccine?
The diphtheria vaccine is an inactivated vaccine that contains a purified diphtheria toxin. Vaccination against diphtheria is free and compulsory. Children and adolescents up to the age of 19 are vaccinated. The diphtheria vaccine is administered as a single pertussis, tetanus and diphtheria vaccine (DTP / DTaP), diphtheria and tetanus (DT) vaccine, and diphtheria only vaccine (monovalent D).
As resistance to diphtheria decreases over time, adults should take booster doses every 10 years. This is especially true for people who come into contact with people from countries where diphtheria is endemic.
The diphtheria vaccine is safe and can cause local reactions such as redness, painful swelling or headaches, and high body temperature. They usually disappear after 24 hours.