A dangerous bacterial infection that often negatively affects the mucous membrane of the throat and nose is called diphtheria. This condition occurs very rarely in the U.S. due to massive vaccination against the disease. In any case, there are a lot of countries with limited health resources or vaccinations that still have many cases of this bacterial infection.
While diphtheria is usually treated with medicines, in advanced stages, it may cause permanent damage to the kidneys, heart, and nervous system. Without treatment, this condition can be deadly, especially during childhood.
Symptoms
In most cases, diphtheria symptoms occur within 5 days after exposure to the bacteria. Check below for some symptoms usually noticed in people with this infection:
- Nasal discharge
- Fever
- Chills
- Tiredness
- Breathing problems (such as fast breathing or difficulty breathing)
- Swollen lymph nodes in the neck
- Hoarseness
- Sore throat
- A gray and thick membrane that covers the tonsils and throat
Sometimes, people experience this infection but without any symptoms, which makes them unaware of their condition. These people are called carriers because they may spread the infection to other people without being sick themselves.
Skin Diphtheria
This infection type is also known as cutaneous diphtheria. This condition negatively affects the skin and may cause pain, redness, and swelling very similar to other bacterial skin infections. In some cases, a gray and thick membrane that appears on the skin may indicate skin diphtheria.
However, this diphtheria type usually occurs in tropical climates but may happen in the U.S. as well. It usually appears among people with poor hygiene and live in crowded conditions.
If you notice that your child has any of the previous symptoms, immediately contact your healthcare professional. Discuss diphtheria vaccination with your physician.
Causes
Generally, this infection is caused by a bacteria called Corynebacterium diphtheriae. When the bacteria enter the body, they begin to multiply on the surface of the throat or skin. Check below for some ways in which C. diphtheriae spreads:
- Airborne droplets – You may become infected with this bacteria when an infected person sneezes or coughs and releases contaminated droplets. If you are near this infected person, you may inhale the bacteria.
- Contaminated household or personal items – You also may get the bacteria from handling other people’s things that are contaminated with the bacteria. Furthermore, if you touch an infected wound, you may also become infected.
If you are infected with this bacteria and do not get treatment, you may spread the infection to other people.
Risk Factors
The following people are at increased risk of developing diphtheria. For example:
- Those who travel to regions with an increased diphtheria risk
- Children and adults who do not have up-to-date vaccinations or weakened immune systems
- People who live in unsanitary or crowded conditions
This infection happens quite rarely in the U.S. and Western Europe because children have been vaccinated against the disease for decades. However, this condition happens commonly in regions where vaccination rates are low and in developing countries. In addition, this condition is a threat to unvaccinated people who travel in areas where diphtheria is common.
What Are The Possible Complications of Diphtheria?
People who ignore the symptoms and do not get treatment for this infection may experience some dangerous complications. Examples include:
- Trouble breathing – The bacteria that causes the infection may produce a toxin that damages the tissue in the throat and nose. Moreover, this bacteria also makes a thick and gray membrane made of dead cells and other substances. Thus, this membrane causes damage to the respiratory system.
- Heart damage – The toxins produced by diphtheria bacteria may enter the bloodstream and cause damage to other body structures and organs (such as the heart muscle). As a result, you may experience myocarditis (inflammation of the heart muscle). In advanced stages, myocarditis may lead to sudden death.
- Nerve damage – This complication also occurs due to toxins made by the diphtheria bacteria. It usually negatively affects the nerves in the throat, which may lead to swallowing problems. Sometimes, the toxin may affect the nerves in other body parts, including arms, legs, and others. In addition, if toxins produced by this bacteria cause damage to the nerves that control muscles involved in breathing, you may need mechanical assistance to breathe.
Usually, people who get treatment survive these complications. However, the recovery is slow in most cases. This infection is fatal approximately 5% to 10% of the time, but the rate elevates in children under 5 years old and people over 40 years old.
How to Prevent Diphtheria?
Previously, diphtheria was a common condition. It usually was treated with antibiotics. However, today, this condition is not only treatable but also may be prevented with vaccination.
Commonly, the vaccine against this infection is combined with vaccines for tetanus and pertussis (whooping cough). Moreover, the latest forms of the vaccine against diphtheria are known as the DTaP for children and Tdap for adolescents and adults.
Three-in-one vaccine (diphtheria, tetanus, and pertussis) is often recommended in the U.S. during infancy. In normal circumstances, for children, this vaccine is administered in five shots in the arm or thigh. Check below when the vaccine is given to children:
- 2, 4, 6 months (three shots)
- 15 to 18 months
- 4 to 6 years
This vaccine is effective in preventing the infection but may cause some adverse reactions. These include mild fever, fussiness, sleepiness, or tenderness. Discuss with your healthcare professional ways to lessen or relieve these negative effects.
In rare cases, this vaccine may cause some complications, but they are treatable. These include an allergic reaction (hives or rash that appears at the injection site). However, children with serious health conditions (such as epilepsy or other nervous system diseases) usually cannot get this vaccine.
What are Booster Shots?
Typically, immunity to diphtheria goes away over time. That’s why doctors recommend booster shots that help maintain your immunity. Usually, people receive their first booster shot between 11 and 12 years old and then every 10 years. This vaccine is recommended, especially if you travel to regions where diphtheria is common.
Diagnosis
Usually, physicians suspect diphtheria during a physical examination. If you have a sore throat with a thick and gray membrane that covers the tonsils and throat, it may indicate an infection. However, to confirm the condition, physicians may perform a laboratory culture of a small sample of the membrane. Moreover, they may perform additional laboratory tests to check for the diphtheria type that negatively affects the skin (cutaneous diphtheria).
The treatment usually begins as soon as your doctor suspects the infection, even without test results.
Treatment
This infection is a dangerous condition, and usually, treatment begins immediately. First, physicians will make sure that your airways are not blocked or narrowed. Some people require a breathing tube in the throat. Check below for some treatments usually recommended by doctors for people with diphtheria:
- Antibiotics – Physicians usually prescribe Penicillin or Erythromycin to destroy bacteria and clear the infection. These medicines also help reduce the time a person with the infection is contagious.
- An antitoxin – Once you are diagnosed with this infection, doctors may recommend an antitoxin to counteract the diphtheria toxin in the body. This medicine comes from the Centers for Disease Control and Prevention (CDC). Usually, this medicine is given to the patients intravenously (IV). Furthermore, physicians should perform some skin allergy tests to check whether you are allergic to the antitoxin or not.
In most cases, both children and adults with diphtheria are treated in the hospital because it helps reduce the risk of spreading the infection to other people.
If you are exposed to an infected person, it is advised to see a doctor. They usually recommend antibiotics and a booster dose that helps prevent the development of the bacteria.
Frequently Asked Questions
What was diphtheria caused by?
This dangerous infection is caused by a bacteria called Corynebacterium diphtheriae. This infection may spread to other people through airborne droplets, contaminated objects, and infected wounds.
What are the potential complications of diphtheria?
Check below for some complications that people with diphtheria may experience:
- Pneumonia and Respiratory failure (in severe cases)
- Myocarditis and heart failure
- Polyneuropathy
- Paralysis
- Bulbar palsy
- Skin infections
- Kidney damage
- Death
This document does not contain a full list of diphtheria complications. Consult with your doctor for more details.
What are the primary symptoms of diphtheria?
These include:
- A gray and thick membrane that covers the tonsils and throat
- Fever
- Nasal discharge
- Swollen lymph nodes in the neck
- Tiredness
- Sore throat
- Hoarseness
If you notice that your child experiences any of the previous symptoms, immediately visit a healthcare provider. Ask your doctor if you have any other questions.
