DIPHTHERIA

General Information

DEFINITION--An acute, highly contagious throat infection. Diphtheria has become a rare disease with the widespread use of immunizations. The diphtheria vaccine is usually given with the vaccines against tetanus and pertussis (whooping cough) to infants (DTP vaccine).

BODY PARTS INVOLVED--Throat; skin; heart; central nervous system.

SEX OR AGE MOST AFFECTED--Older children (5 years and up), adolescents and adults.

SIGNS & SYMPTOMS

Early stages:

• Sore throat.
• Low fever.
• Swollen neck glands.

Late stages:

• Airway obstruction and breathing difficulty.
• Shock (low blood pressure; rapid heartbeat; paleness; cold skin; sweating; anxious appearance).

CAUSES--A bacteria, Corynebacterium diphtheriae, infects the throat and sometimes the skin. The bacteria produces poisons that spread to the heart, central nervous system and other organs.

RISK INCREASES WITH

• Adults over 60, children under 5.
• Poor nutrition.
• Outbreak in the community.
• Crowded or unsanitary living conditions.
• Lack of up-to-date immunizations.
• Alcoholism.

HOW TO PREVENT

• Immunization with diphtheria vaccine.
• Improved nutrition and standard of living.
• Notify the local health department of any case of diphtheria. Anyone having contact with the patient must be examined and treated.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies, such as throat culture and blood counts.

APPROPRIATE HEALTH CARE

• Doctor's treatment. This is a medical emergency.
• Hospitalization and isolation of the patient until fully recovered. Protect susceptible individuals (the non-immunized, very young or elderly) from exposure.
• Patients may require mechanical assistance in breathing.

POSSIBLE COMPLICATIONS

• Heart inflammation and heart failure.
• Suffocation.
• Nerve inflammation.
• Misdiagnosis as a less-serious infection, resulting in dangerous delay of treatment.

PROBABLE OUTCOME--Usually curable in 1 week, followed by slow recovery for several weeks. A delay in treatment may result in death or long-term heart disease.

How To Treat

GENERAL MEASURES--

• Dispose of all secretions (nose and mouth) and excretions (urine and feces) in an acceptable manner. Call the local health department for instructions.
• People who have been in close contact with the patient and who have not been immunized should have throat cultures and be immunized. They should be watched closely for possible symptoms. A booster vaccine may be given for people who have been immunized.

MEDICATION--Your doctor may prescribe:

• Diphtheria antitoxin to neutralize the diphtheria toxin.
• Antibiotics to fight remaining diphtheria organisms.

ACTIVITY--Prolonged bed rest (2 to 3 months or until fully recovered), especially if the heart is involved.

DIET--Liquid to soft diet as tolerated.

Call Your Doctor If

• You have symptoms of diphtheria or observe them in someone else.
• Anyone in your family is exposed to diphtheria.
• Your immunizations are not current.
• The following occurs during treatment: Temperature spikes to 102F (38.9C). Increasing breathing difficulty. Increasing shortness of breath. Confusion.