Diphtheria is a serious bacterial infection caused by Corynebacterium diphtheriae. Once a major global health threat, it is now less common in many regions due to vaccination efforts. However, diphtheria remains a relevant concern, especially in areas with low immunization rates.
What is Diphtheria and How it Spreads
The bacterium Corynebacterium diphtheriae typically infects the throat and nose. This bacterium produces a potent toxin that can spread through the bloodstream, potentially damaging various organs throughout the body. The toxin interferes with protein synthesis in cells, leading to tissue destruction.
Diphtheria primarily spreads through respiratory droplets released when an infected person coughs or sneezes. Close contact with an infected individual can also facilitate transmission. The bacterium can also spread through direct contact with discharge from infected skin lesions. Even individuals who do not show symptoms but carry the bacteria can transmit the disease.
Identifying the Symptoms
Symptoms of respiratory diphtheria often begin subtly, resembling a common cold or sore throat. A distinguishing feature is the formation of a thick, gray pseudomembrane, which develops in the throat or nose, sometimes extending into the windpipe. This membrane can cause difficulty breathing and swallowing.
Individuals may also experience a sore throat, hoarseness, and swollen neck glands, sometimes leading to a characteristic “bull neck” appearance. Fever often accompanies these symptoms. Diphtheria can also affect the skin, causing cutaneous diphtheria, which presents as non-healing skin ulcers often covered with a grayish membrane. Prompt medical attention is necessary if symptoms appear.
Treating Diphtheria
Treating diphtheria involves immediate action to neutralize the toxin and eliminate the bacteria. The primary treatment is diphtheria antitoxin (DAT), which is derived from horses. This antitoxin binds to and neutralizes the circulating toxin in the bloodstream, preventing further tissue damage. Before administration, patients are typically tested for allergic reactions to the antitoxin due to its animal origin.
Antibiotics, such as penicillin or erythromycin, are also given to kill the Corynebacterium diphtheriae bacteria. This stops further toxin production and prevents the spread of the infection to others. Supportive care is also provided, including maintaining an open airway, managing fluid balance, and monitoring for complications. Patients usually require hospitalization to prevent further transmission.
Protection Through Vaccination
Vaccination is the most effective method for preventing diphtheria. The diphtheria vaccine is administered as part of combination vaccines to protect against multiple diseases. For infants and young children, the DTaP vaccine provides protection against diphtheria, tetanus, and pertussis (whooping cough). This vaccine is given in a series of doses during early childhood.
Adolescents and adults receive booster shots, usually with the Tdap or Td vaccine. These boosters are recommended every 10 years to maintain strong immunity against diphtheria. Adhering to the recommended immunization schedule for all age groups is important for individual protection and contributes to herd immunity, which helps protect those who cannot be vaccinated. High vaccination rates significantly reduce the circulation of the bacterium within communities.
Serious Health Risks
If not treated promptly, the bacterial toxin can lead to several serious health complications. One severe complication is myocarditis, which involves damage to the heart muscle. This can result in abnormal heart rhythms or heart failure, posing a significant threat to life.
Nerve damage, or neuropathy, is another potential consequence, which can manifest as paralysis, particularly affecting the muscles of the throat, making swallowing difficult. This nerve damage can also impact other parts of the body. Kidney damage can also occur, impairing the organ’s ability to filter waste from the blood. Additionally, the pseudomembrane in the throat can cause severe respiratory obstruction, potentially leading to suffocation.