Diphtheria is a bacterial disease that can cause a sore throat, difficulty breathing, and fever. It was common in the early 1900s, but the DTap vaccine has made it a rare disease in the U.S. Dr. Bornstein discusses symptoms, causes, diagnosis and treatment for diphtheria.
DEFINITION:
An acute illness caused by a toxin released from the bacterium Corynebacterium diphtheriae.
SYMPTOMS:
- Runny nose and congestion
- Fever
- Sore throat
- Difficulty breathing leading to
- Stupor
- Coma
- Death
CAUSES:
A toxin is released from the bacterium Corynebacterium diphtheriae.
CONTAGION:
Diphtheria is a contagious illness spread by coughing, sneezing, or talking. The illness incubates over two to four days.
DIAGNOSIS:
A white membrane can be seen in the nose or mouth. When the membrane is scraped, bleeding occurs. This, combined with the symptoms, makes diphtheria a possibility. A culture for the bacteria from scraping the membrane will confirm the diagnosis.
TREATMENT:
The treatment depends on removing the toxin from the body. Giving anti-toxin does this. Antibiotics such as penicillin or erythromycin are also provided to kill the bacteria producing the toxin. Supportive measures such as fluids, bed rest, and good nutrition can be taken if the disease progresses.
OUTCOME:
Before anti-toxins and antibiotics were available, there was a 50% death rate. This was due to suffocation from the membrane covering the airway. With antibiotics and anti-toxins, the mortality rate is less than 5% and is due to complications such as myocarditis (heart disease). With vaccination, the illness is extremely rare.
DISCUSSION:
Although there is still a long way to go, diphtheria is slowly being eradicated due to vaccination. The illness is highly contagious, and susceptible individuals are at high risk. The illness usually starts as a simple cold, but it can rapidly progress to the mouth and throat, causing an obstructed airway. A white or gray membrane can be seen in the nose or mouth. If the illness is suspected, immediate treatment is necessary to prevent progression. Complications of this illness include airway obstruction, myocarditis (heart disease), and neurologic problems such as paralysis of the eyes, diaphragm, and limbs. Once diagnosed, both treatment and isolation are necessary. Any exposed individuals should receive diphtheria toxoid and a shot of penicillin. The vaccine is the only way to prevent contracting the illness. The vaccine is part of the DTaP given at two, four, and six months of age, with a booster dose at fifteen months and four years of age.
ONE DOCTOR’S OPINION:
This disease, which was previously widespread in the United States, has now become rare thanks to the availability of vaccination. It is recommended that everyone should receive the vaccine, as it has no severe side effects. Even though outbreaks are still occurring in Eastern Europe and Russia, we should not become complacent and neglect the vaccine. The illness is easily preventable and can have severe consequences if contracted. Therefore, it is highly recommended that we take vaccination seriously.
This blog was written by Dr. Michael Bornstein, who has 30 years of experience as a pediatrician.
Disclaimer: The contents of this article, including text and images, are for informational purposes only and do not constitute a medical service. Always seek the advice of a physician or other qualified health professional for medical advice, diagnosis, and treatment.
FOLLOW US