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Diphtheria

What is diphtheria?

Diphtheria is an infection caused by the toxin-producing bacterium, Corynebacterium diphtheriae. Usually, the incubation period is 2-5 days after the exposure but occasionally longer. Patients commonly present with sore throat, fever, palpable lymph nodes over the neck, and thick, grey, adherent membranes over the tonsils and throat. Diphtheria may be complicated by airway obstruction causing breathlessness. Toxic effects on the nervous system may occur after several weeks causing temporary paralysis of muscles.

How does it spread?

The bacterium is transmitted through direct person-to-person contact. Rarely it spreads through articles soiled by a patient's discharge. Humans are the only natural host of the organism.

How can you prevent it?

Immunization is the mainstay for prevention of Diphtheria. Diphtheria vaccine is usually combined with tetanus toxoid and pertussis vaccine as triple vaccine (DTP). Diphtheria vaccination is one of the recommended childhood immunizations and should begin during infancy. A minimum of 3 injections should be given as approximately 85% of people will be protected against Diphtheria for at least 10 years after 3 injections of diphtheria vaccine, and if available, a total of 5 injections are strongly recommended.

In 1994, a Diphtheria outbreak occurred in the former Soviet Union, as a result of failure in the Diphtheria immunization campaign, causing a toll of 1,500 deaths. Travellers are advised to consult their family physician if there is doubt about the completion of vaccine before travelling to places where Diphtheria is prevalent. Booster injections at 10-year intervals may be considered to maintain protection.

How is it treated?

The patient should be isolated in hospital with supportive treatment given such as oxygen, intravenous fluid and heart monitoring. Diphtheria antitoxin is given by injection as soon as the diagnosis is suspected. Antibiotic such as penicillin is indicated as an adjunct of treatment. Immunization is given to all contacts of the infected person, including health care personnel. The death rate is about 10% and recovery from illness is slow.

 


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Last revision date: 10 October 2012