Diphtheria

Overview of Diphtheria

Diphtheria also known as (Halaq ki bemari / حلق کی بیماری)was one of the leading fatal endemic diseases that had increased the ratio of children's death all over the world, before the development of the current vaccine. As per the WHO report of 2018, more than 16,000 cases of diphtheria were reported. Hence, proper vaccination for children is required to combat diphtheria.

Diphtheria is an upper respiratory infectious disease caused by the bacterium Corynebacterium diphtheriae. It typically infects the throat and upper airways, producing a harmful toxin affecting other organs. The condition is contagious and spreads through physical contact, coughing, or sneezing.

Signs and Symptoms of Diphtheria

Diphtheria can cause infection in the respiratory tract and skin. Symptoms of diphtheria depend on the bacterial infection on the particular organ or part of the body.

1. Respiratory Diphtheria Symptoms

Primarily, bacterial diphtheria targets the lining of the respiratory system that involves breathing. In this manner, it may cause:

  • Sore throat
  • Swollen glands in the neck region
  • Weakness
  • Mild fever

The harmful bacteria produce a toxin that kills healthy tissues and converts them into dead tissues in the respiratory system. The dead tissue layer makes a thick grey coating within two or three days and accumulates in the throat or nose. A thick grey coating is known as a"pseudomembrane." This membrane can form in the nose, tonsils, voice box, and throat tissues, making breathing and swallowing difficult.

If a harmful toxin transfers into the bloodstream, it may damage the heart, nerves, and kidneys.

2. Diphtheria Skin Infection Symptoms

Skin is also infected by deadly bacteria forming an open sore or ulcers. Though, diphtheria skin infections rarely affect any other chronic disease.

Types of Diphtheria

Causes of Diphtheria

As previously explained, diphtheria is a life-threatening infection caused by a pathogenic strain of bacteria called Corynebacterium diphtheriae that produces a poisonous toxin. These deadly toxins are responsible for making people ill.

Diphtheria is majorly transmitted by:

  • Respiratory Droplets: Such as coughing or sneezing. 
  • Infected open sores or Ulcers: If a person touches the open sores or ulcers of sick people, that person will also be affected by it.
  • Usage of Contaminated Personal or Household Items: Most people can easily catch diphtheria bacteria by handling an infected person's items like used tissues or hand towels, etc.
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Risk Factors of Diphtheria

There are various risk factors for diphtheria such as:

  • People are unlikely to be vaccinated with up-to-date vaccines, especially children and adults.
  • People who are living in crowded or unhygienic conditions
  • People who are traveling to other countries where diphtheria infections are more common.

Health Complications of Diphtheria

Health Complications occur when bacteria infect parts of the body, such as:

  • Cause damage to your heart muscles
  • Kidney failure
  • Loss of the ability to move
  • Nerve damage
  • Airway blockage

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Prevention

If someone comes in contact with a person who is infected with diphtheria bacteria then he/she should immediately consult the doctor for testing and treatment. A pulmonologist will treat the exposed person with the help of the:

  • Antibiotics are used to eliminate bacteria from the respiratory system
  • A booster dose of the diphtheria vaccine enhances immunity.

Vaccination is the most effective way to prevent diphtheria. DT, Td, Tdap, and DTaP are the recommended vaccines for diphtheria.

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Diagnosis

A pulmonologist or medical specialist diagnoses diphtheria in a sick child with a sore throat by identifying the grey membrane covering the throat or tonsils. 

The identification test of diphtheria is done through a laboratory throat culture test.

  • Laboratory Throat Culture Test: During this procedure, the grey membrane material is extracted from the throat for analysis. Additionally, that study will evaluate the type of bacteria and how much toxic bacteria affect the skin. If a culture test is positive, a doctor will instantly begin the treatment.

Treatment of Diphtheria | When to Consult a Doctor

Diphtheria is a lethal infection. Pulmonologists believe in immediate and aggressive treatment action, which is highly required. Treatments include:

  • Antibiotics: These medications are used to kill bacteria and treat infections quickly. The example of such antibiotics are:
  • Penicillin 
  • Erythromycin
  • An Antitoxin: If the pulmonologists suspect diphtheria, they will quickly prescribe antitoxins to stabilize the toxin in the body. The antitoxins are in the form of injection and will inject into the vein or muscle. A skin allergy test of the patients is performed before instilling the antitoxins, to assure whether the victim is allergic to it. If the patient has an allergy then that person needs to be desensitized to the antitoxin by giving small doses to them. After that, a doctor elevates the dose slowly.

The medical health practitioner will isolate the patients in a separate room of the intensive-care unit. That's why an infected person will recover rapidly and can protect those individuals who are not immunized against the disease.

It is essential to give diphtheria vaccines to children for their safety and prevention. This is the most initial and reliable treatment and helps to cure diphtheria.

(Note: Take medication only after your doctor’s recommendation)

  • Diphtheria Vaccination Dose

As per WHO recommendation, vaccination diphtheria vaccination is given to children. Here is how vaccination should be given to children.

Primary Vaccination and 3 Booster Doses:  A series of 3-dose primary vaccinations containing diphtheria vaccine and 3 booster doses. It should begin as early as when the baby is 6 weeks of age with constant doses at least 4 weeks intervals between the doses. The 3 booster doses should particularly be given to 12-23 months babies, at 4-7 years kids, and at 9-15 years children. Ideally, there must be a minimum of 4 years difference between booster doses.