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Diphtheria

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Definition

Diphtheria is a life-threatening infection that spreads very easily. It is caused by bacteria. The infection most commonly attacks the mucus membranes (the tonsils, throat, and nose). It can also infect the skin. Some types of the bacteria can also cause damage to the heart, nerves, kidneys, and brain.
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 better the outcome will be.

Causes

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

Risk Factors

Factors that increase your chance of getting a diphtheria include:
  • Having never been immunized against diphtheria
  • Not having had a booster dose in the past ten years
  • Having a compromised immune system

Symptoms

Signs and symptoms of diphtheria usually begin 2 to 5 days after a person is infected. The most obvious sign of diphtheria is a gray covering on the back of the throat. The covering 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:
  • Sore throat and painful swallowing
  • Fever up to 103°F
  • Cough, possibly a barking cough
  • Swollen glands in the neck
  • Difficulty breathing
  • Difficulty swallowing
  • Weakness
  • Gray covering on the back of the throat
  • Skin infection
Swollen Lymph Nodes
Swollen lymph node
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Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Diphtheria will be suspected if the throat and tonsils are covered with a gray membrane.
Your doctor may need to test to confirm the diagnosis. This can be done by collecting a tissue sample.

Treatment

Talk with your doctor about the best treatment plan for you. If your doctor suspects diphtheria, your treatment will start right away, even before the lab results are returned. Treatment options include the following:
  • Antitoxin injection
  • Antibiotics
  • Isolation and bedrest

Prevention

The vaccine for diphtheria is safe and is very effective at preventing the disease. All children (with few exceptions) should receive the DTaP vaccine series. This protects against diphtheria, tetanus , and pertussis . Another vaccine called Tdap is routinely given to children aged 11-12 years after they have completed the DTaP series of shots. After that, adults should receive a booster dose of the tetanus and diphtheria vaccine (Td) every 10 years or after exposure to tetanus (in some cases).
If you or your child has not been fully vaccinated, talk to the doctor. There are catch-up schedules available.

RESOURCES

Centers for Disease Control and Prevention National Immunization Program http://www.cdc.gov/

National Foundation of Infectious Diseases (NFID) http://www.nfid.org/

National Institute of Allergy and Infectious Diseases http://www3.niaid.nih.gov/

World Health Organization http://www.who.int/

CANADIAN RESOURCES

HealthLinkBC http://www.healthlinkbc.ca/

Caring for Kids The Canadian Paediatric Society http://www.caringforkids.cps.ca/

References

Epidemiology and Prevention of Vaccine-Preventable Diseases . 12th ed (May 2012). Published by the National Immunization Program, Centers for Disease Control and Prevention, US Department of Health and Human Services. Available at: http://www.cdc.gov/vaccines/pubs/pinkbook/index.html#order. Accessed January 7, 2013.

Recommended adult immunization schedule—United States, 2012. MMWR Morb Mortal Wkly Rep . 2012;6(4). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/downloads/adult/mmwr-adult-schedule.pdf . Accessed January 7, 2013.

Recommended immunization schedule for persons aged 0 through 6 years—United States 2012. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/downloads/child/0-6yrs-schedule-pr.pdf . Accessed January 7, 2012.

Recommended immunization schedule for persons aged 7 through 18 years—United States 2012. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/downloads/child/7-18yrs-schedule-pr.pdf . Accessed January 7, 2013.

Td or Tdap vaccine: what you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-td-tdap.pdf . Published January 24, 2012. Accessed January 7, 2013.

1/24/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine from the advisory committee on immunization practices, 2010. MMWR Morb Mortal Wkly Rep. 2011;60(1):13-15.

11/4/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant aged <12 months—Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep. 2011;60:1424-1426.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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