Diphtheria is a serious bacterial infection that affects the mucous membranes of the throat and nose. Although it spreads easily from person to person, diphtheria can be prevented through vaccination.

What Causes Diphtheria?

Diphtheria is caused by the bacterium Corynebacterium diphtheriae; the condition is typically spread through person-to-person contact or by touching objects contaminated by the bacteria, such as cups or cutlery. It is also possible to contract diphtheria if an infected person sneezes, coughs, or blows their nose nearby. Even if an infected person does not show signs or symptoms of diphtheria, they can still transmit the bacterial infection for up to six weeks after the initial infection.The bacteria usually settle in the nose and throat, and once infection occurs, they release dangerous substances called toxins. These toxins spread through the bloodstream and often cause thick, grayish patches on the nose, throat, tongue, and upper airways. In more severe cases, there may be significant swelling of the neck, with enlargement of the lymph nodes. This can cause difficulty breathing or a complete blockage of the airway.These toxins can also damage other organs, including the heart, brain, and kidneys. This can lead to potentially fatal complications such as myocarditis, paralysis, or kidney failure.

Risk Factors for Diphtheria

Anyone can contract diphtheria. However, certain groups are at higher risk:

  • Children and adults who have not been vaccinated
  • People traveling to regions where there is no immunization against diphtheria
  • People with some type of immune system disorder, such as AIDS
  • People living in overcrowded conditions or unhealthy environments

In Brazil, children are vaccinated against diphtheria, so the disease is considered rare. However, diphtheria is still quite common in developing countries where immunization rates are low.In these countries, children under 5 years old and people over 60 are particularly at risk of contracting diphtheria.

Symptoms of Diphtheria

Signs of diphtheria generally appear within two to five days after infection occurs. Some people do not experience symptoms, while others have mild symptoms similar to those of the common cold.

  • The most visible and common symptom of diphtheria is a thick, gray membrane covering the throat and tonsils. Other common symptoms include:
  • Fever and chills
  • Swollen lymph nodes in the neck
  • Sore throat and hoarseness
  • Cough
  • Bluish skin
  • Difficulty swallowing
  • Nasal discharge
  • Malaise.

Additional Symptoms

Additional symptoms may occur as the infection progresses, including:

  • Difficulty breathing or rapid breathing
  • Changes in vision
  • Slurred speech
  • Signs of shock, such as pale and cold skin, sweating, and rapid heartbeat

It is possible to develop cutaneous diphtheria (or skin diphtheria, as it is called) if you have poor hygiene or live in a tropical area. Skin diphtheria generally causes ulcers and redness in the affected area.

How is Diphtheria Diagnosed?

The diagnosis of diphtheria is made based on a physical examination. The doctor will check for gray patches on the tonsils and throat, as well as swelling of the neck lymph nodes. They will also ask about your medical history and experienced symptoms.To confirm the diagnosis, the doctor will take a sample from the affected tissue, which can be from either the throat or skin, and send it to a laboratory for testing.

Treatment for Diphtheria?

Diphtheria is a serious condition, so the doctor will begin treatment quickly and aggressively. The first step in treatment is an antitoxin injection, administered into a vein or muscle. It is used to neutralize the toxin produced by the bacteria that is already circulating in the body.It is important to inform your doctor if you have any kind of allergy to the antitoxin. In that case, treatment can be started with small doses and gradually increased as treatment progresses.The doctor will also prescribe antibiotics, such as erythromycin and penicillin, to help control the infection. The medical team may also remove some of the membranes that form in the throat if they are obstructing breathing.During treatment, the doctor may recommend hospitalization, so that the patient avoids infecting others, especially those they have daily contact with. Only a doctor can determine the most appropriate medication for each case, as well as the correct dosage and duration of treatment. Always follow your doctor’s instructions closely and never self-medicate.Do not stop taking the medication without consulting a doctor first and if you take it more than once or in much larger amounts than prescribed, follow the instructions in the insert.

How is Diphtheria Prevented?

The best way to prevent diphtheria is through vaccination, which can be the diphtheria-tetanus-pertussis (DTP) or the pentavalent vaccine. The classic DTP vaccine (diphtheria, tetanus, and acellular pertussis) is recommended for children up to seven years of age. After that, the Tdap vaccine (acellular adult-type diphtheria, tetanus, and pertussis) is used.There is also the pentavalent vaccine, indicated for the active immunization of children from two months of age against diphtheria, tetanus, pertussis, hepatitis B and diseases caused by Haemophilus influenzae type b.Both vaccines are available in the official calendar of the Ministry of Health and are given to children at the following ages:

  • 2 months
  • 4 months
  • 6 months
  • 15 to 18 months
  • 4 to 6 years

The vaccines last for 10 years, after which the child will need to be vaccinated again around the age of 12. In rare cases, a child may have an allergic reaction to the vaccine, which can result in seizures or skin allergies that will go away after a few days.People who did not receive this vaccine as children should seek immunization, especially healthcare professionals, garbage collectors, workers handling sewage and contaminated water, food and beverage handlers, firefighters, military personnel, police, manicurists and pedicurists, aviation professionals, people who travel often, and those who work with children or animals. In these groups, vaccination is especially recommended.Also see: Vaccines in Pregnancy – Which Main Ones to TakePhotos: James Gathany