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Concept
Diphtheria
Summary
Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. Most infections are asymptomatic or have a mild clinical course, but in some outbreaks the lethality rate approaches 10%. Signs and symptoms may vary from mild to severe and usually start two to five days after exposure. Symptoms often develop gradually, beginning with a sore throat and fever. In severe cases, a grey or white patch develops in the throat, which can block the airway and create a barking cough similar to what is observed in croup. The neck may also swell in part due to the enlargement of the facial lymph nodes. Diphtheria can also involve the skin, eyes or genitals, and can cause complications including myocarditis (which in itself can result in an abnormal heart rate), inflammation of nerves (which can result in paralysis), kidney problems, and bleeding problems due to low levels of platelets.
Diphtheria is usually spread between people by direct contact, through the air, or through contact with contaminated objects. Asymptomatic transmission and chronic infection is also possible. Different strains of C. diphtheriae are the main cause in the difference of lethality, the lethality and symptoms themselves being caused by the exotoxin produced by the bacteria. Diagnosis can often be made based on the appearance of the throat with confirmation by microbiological culture. Previous infection may not protect against infection.
A diphtheria vaccine is effective for prevention and available in a number of formulations. Three or four doses, given along with tetanus vaccine and pertussis vaccine, are recommended during childhood. Further doses of diphtheria–tetanus vaccine are recommended every ten years. Protection can be verified by measuring the antitoxin level in the blood. Diphtheria can be prevented in those exposed as well as treated with the antibiotics erythromycin or benzylpenicillin. A tracheotomy is sometimes needed to open the airway in severe cases.
In 2015, 4,500 cases were officially reported worldwide, down from nearly 100,000 in 1980.
Official source
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