Infectious Diseases

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Diphtheria

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What is Diphtheria?

Diphtheria is a serious disease that is caused by germs that infect the nose, throat or skin. It can cause serious problems with breathing and can also cause heart failure and nerve damage. Diphtheria has become a rare disease because of children’s routine immunizations.

How is it spread?

Diphtheria is passed to others through coughing and sneezing or by contact with fluid from skin lesions of an infected person.  In untreated people, diphtheria can be present in discharge from the nose and throat and from eye and skin lesions for 2 to 4 weeks. The bacteria can be passed through very close contact with people who have the germs in their nose, throat or on their skin and who have travelled to areas where diphtheria is more commonly seen.  Rarely fomites and raw milk or milk products can serve as a source for transmission.

What are the symptoms?

Signs and symptoms of diphtheria may include:

  • Sore throat and hoarseness
  • Painful swallowing
  • Swollen glands in your neck
  • A thick, gray membrane covering the throat and tonsils
  • Difficulty breathing or rapid breathing
  • Nasal discharge
  • Fever and chills

Diphtheria can also affect the skin, resulting in ulcers covered by a gray membrane. Symptoms typically appear two to five days after someone becomes infected. People may experience a mild case of the illness or have no signs or symptoms of the disease.  These people are said to be ‘carriers’ of the disease as they may spread the bacteria without knowing they are sick.

How is Diphtheria diagnosed?

Diphtheria may be suspected in an individual who has a sore throat with a gray membrane covering the tonsils and throat. Diagnosis of diphtheria is done by taking a sample of the gray membrane from the person’s throat with a swab and having the sample grown (cultured) in a laboratory. Doctors can also take a sample of tissue from an infected wound and have it tested in a laboratory, to check for the type of diphtheria that affects the skin (cutaneous diphtheria).

What is the treatment for Diphtheria?

Diphtheria is a serious illness requiring immediate and aggressive treatment with these medications:

  • Antitoxin After confirmation that a person has diphtheria, the infected person receives a special antitoxin. The antitoxin neutralizes the diphtheria toxin already circulating in the body. Doctors may perform skin allergy tests to make sure that the infected person doesn't have an allergy to the antitoxin. People who are allergic must first be desensitized to the antitoxin. Doctors accomplish this by initially giving small doses of the antitoxin and then gradually increasing the dosage.
  • Antibiotics Diphtheria is also treated with antibiotics.Antibiotics help kill bacteria in the body, clearing up infections. Antibiotics reduce to just a few days the length of time that a person with diphtheria is contagious.  
Children and adults who have diphtheria often need to be in the hospital for treatment. They may be isolated in an intensive care unit because diphtheria can spread easily to anyone not immunized against the disease.
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