Diphtheria

Diphtheria is a highly contagious and life-threatening infection caused by bacteria. The infection most commonly attacks the mucus membranes associated with the breathing system (the tonsils, throat, and nose) and can also infect the skin. In addition, some types of the bacteria can cause damage to the heart, nerves, kidneys, and brain.

The vaccine for diphtheria is safe and is very effective at preventing the disease. A series of shots are given during childhood, then booster shots are required every ten years to keep the immunity strong.

Before vaccines and medicines were available to prevent and treat the disease, nearly one out of ten people who got diphtheria died. It was the leading cause of death among children.

Diphtheria is a medical emergency that requires immediate care from your doctor. Not everyone who gets diphtheria shows signs of illness, though they may be able to infect others. The sooner it is treated, the more favorable the outcome.

Diphtheria is caused by the bacteria Corynebacterium diphtheriae . The infection spreads from person to person through contact with:

• Droplets of moisture that are coughed or sneezed into the air by an infected person and breathed in by a noninfected person
• Personal items, such as tissues or drinking glasses, that have been used by an infected person
• Skin that is infected with diphtheria

A risk factor is something that increases your chance of getting a disease or condition. Risk factors include:

• Being undernourished
• Having a compromised immune system
• Having never been immunized against diphtheria
• Living in crowded or unsanitary conditions
• Not having had a booster dose in the past ten years

Signs and symptoms of diphtheria usually begin 2 to 5 days after a person is infected. The most telltale sign of diphtheria is a gray covering on the back of the throat, which can detach and block the airway. If left untreated, the bacteria can produce a poison that spreads through the body causing damage to the heart, nerves, and kidneys.

Symptoms include:

• Difficulty breathing
• Difficulty swallowing
• Fever up to 103°F
• Gray covering on the back of the throat
• Sore throat and painful swallowing
• Swollen glands in the neck
• Weakness

Your doctor will ask about your symptoms and medical history and perform a physical exam. Diphtheria will be suspected if the throat and tonsils are covered with a gray membrane. Tests to confirm a diagnosis may include:

• A sample of the gray membrane that coats the back of the throat
• A sample of tissue from an infected area of skin

Talk with your doctor about the best treatment plan for you. If your doctor suspects diphtheria, your treatment will start immediately, even before the lab results are returned. Treatment options include the following:

• Antibiotics—A substance, injected or given as a pill, that kills the diphtheria bacteria in the body and heals the infection. It also reduces the length of time a person is contagious.
• Antitoxin—A substance, injected into the body, which neutralizes the diphtheria poison that is traveling in the body.
• Isolation and bedrest—It takes a long time, up to six weeks, to recover from diphtheria, especially if the heart was affected. Isolation may be necessary while a person is still contagious.

The best means of prevention is immunization. All children (with few exceptions) should receive the DTaP vaccine series. This protects against diphtheria, tetanus, and pertussis.

Another vaccine called Tdap is given to children aged 11-12 after they have completed the DTaP series of shots. Children aged 7-10 years old who did not get the full DTaP vaccine series may also get the Tdap vaccine. A booster dose of Tdap may also be given once to teens and adults who did not get the Tdap vaccine at age 11-12 years.

There is also a booster dose of the tetanus and diptheria vaccine (Td). This is given every 10 years or after an exposure to tetanus (in some cases).

Talk to the doctor if you or your child has not been fully vaccinated.