Diphtheria

diphtheria doses

Overview of diphtheria

Microbial infections are common in the tropics and the subtropics. These regions have climatic and environmental conditions that are optimum for microbial growth. In due course of time, these diseases turn into epidemics and result in millions of fatalities. Diphtheria is one such disease caused by the bacterial species Corynebacterium diphtheriae. It is mainly observed in people who lack immunity due to nutritional deficits or for not being immunized in childhood.  In the year 2013, nearly 4700 cases of diphtheria were reported, with 3300 cases leading to death. Although the mortality rates have been brought down by a significant percentage, the current global burden is still quite high and needs to be addressed seriously.

 

What is diphtheria?

Diphtheria is a type of contagious disease triggered by the bacterium Corynebacterium diphtheria. It derives its name from the Greek term “diphthera” which means “leather hide”. The onset of the disease is marked by a sore throat and fever. In the more advanced stages, greyish or whitish patches appear in the throat. This partially blocks the air passage and produces a hoarse cough. It is preventable by means of adequate vaccinations.

 

How does the disease occur?

Diphtheria in kidsThe pathogenesis of diphtheria is complex. The immunosuppressed people acquire the diphtheria bacilli in the nasopharynx. This pathogen then produces a particular toxin that impedes cellular protein synthesis. This is then followed by the destruction of the local tissues and the formation of pseudomembrane. The toxin generated at the site of this membrane is henceforth absorbed into the bloodstream and is circulated to the important tissues of the body. This toxin leads to certain serious complications such as- low platelet count (thrombocytopenia) and presence of protein in the urine (proteinuria). Another non-toxic variant of this pathogen can lead to mild pharyngitis, but do not give rise to the formation of pseudomembrane.

 

How does the disease spread?

Diphtheria is a highly communicable disease and spreads via human to human transmission. The disease mainly spreads via respiratory droplets discharged when the infected person coughs or sneezes. These droplets when inhaled by a healthy person cause infection. A direct contact with the skin lesions can also transmit the infection. Indirect infections may also take place if the patient uses any object which is later used by a healthy person. Sharing of common items of use such as towels, bed-sheets and utensils with the patient can also cause infection. Zoonotic transmission (animal to human transmission) is also possible, but rare.

 

What are the main signs and symptoms of the disease?

The symptoms of Diphtheria begin around 2-7 days (incubation period) after the infection. The disease mainly manifests through the following signs and symptoms-

  • Low-grade fever (100.4oF)
  • Occasional chills
  • Fatigue and general malaise
  • Bluish discoloration of the skin (cyanosis)
  • A sore throat
  • Formation of a thick coating at the back of the throat
  • Unusual hoarseness of the voice
  • Barking cough
  • A constant headache
  • Problems in swallowing
  • Difficulty breathing
  • Smelly nasal discharge with blood
  • Lymphadenopathy
  • Increased heart rate
  • Myocarditis
  • Cranial and peripheral nerve palsies

 

What are the different types of diphtheria?

diphtheria dosesBased on the pathophysiology and the site affected, the following classification of the disease is done-

  • Anterior nasal diphtheria: The onset of this type mimics common cold and flu. The patients tend to have a mucopurulent nasal discharge which may even contain blood. Clinical examination reveals the formation of a white membrane on the nasal septum. The comparatively low absorption of the toxins makes the symptoms mild.
  • Pharyngeal and tonsillar diphtheria: The pharynx and the tonsils are the commonly affected sites in diphtheria. The systemic absorption of toxin is quite high in this case. The early symptoms of the disease include but are not limited to- mild fever, soreness of throat, general malaise and eating disorders (anorexia). Within 2-3 days, a bluish-white membrane develops on the tonsil and extends to cover a part of the soft palate. As the disease progresses, this membrane turns greenish, greyish or blackish along with bleeding. Mild to moderate mucosal erythema occurs in the vicinity of the membrane. Obstruction of the respiratory passage may occur at a later stage due to excessive pseudomembrane formation.
  • Laryngeal diphtheria: It involves the larynx and often occurs as a progression of the pharyngeal type. The patients have fever, hoarseness of voice and a barking cough. Here also a membrane forms on the tonsil and the palate, which may lead to respiratory blockage. In the end stage, these patients may suffer from coma and death. In laryngeal diphtheria, the patients are often found to have swollen neck and throat, also known as “bull neck”. It is accompanied by a characteristic barking cough and hoarseness of voice. All these symptoms are collectively known as diphtheritic croup.
  • Cutaneous diphtheria: It is also known as skin diphtheria. It mainly affects the inhabitants of the tropical zone. Rashes and ulcers form on the skin. These eruptions are usually very scaly with prominent borders and membrane. Microbes other than the Corynebacterium diphtheria may also be present at the site of infection. Some of the commonly affected sites in this type are the vulvovaginal area, the mucous membranes of the conjunctiva and the external auditory canal.

 

What are the main diagnostic criteria?

Diphtheria cultureCDC has devised the following diagnostic criteria for the disease-

  • Laboratory criteria: Includes throat culture and histopathologic diagnosis
  • Clinical criteria: Upper respiratory tract illness, sore throat, low-grade fever, a sticky, dense grey pseudomembrane.

 

How can you treat and prevent the disease?

CDC recommends the following medications for diphtheria-

  • Metronidazole
  • Erythromycin: Given orally or injected
  • Procaine Penicillin G: Intramuscular injection

The best prevention against this disease is to get vaccinated. The available vaccines are DTaP, Tdap, DT, and Td. These provide immunity from diphtheria and tetanus. DTap and DT are administered to children younger than 7 years of age. Diphtheria is a life-threatening disease that can lead to a number of serious complications and even death. Studies have shown that the overall case-fatality rate for diphtheria is as high as 20% in people less than 5 years or greater than 40 years of age. Timely immunizations along with booster doses can help minimize this burden to a considerable extent.

Facts

  • In 1921, there were 206,000 cases of diphtheria diagnosed in the USA. By widespread use of vaccinations, this was reduced to just 2 cases from 2004 to 2015.
  • The worldwide prevalence of this disease is around 7,321 as per a 2014 report.

Facts

  • The bacterium responsible for diphtheria (Corynebacterium diphtheria) causes the inflammation of cardiac muscles and nerves which can cause paralysis and is highly fatal.

Facts

  • The microbes generally spread with contact with an infected person but can also occur by ingestion of unpasteurized milk.
  • Living in crowded and poorly sanitized areas and having lower immunity levels can act as risk factors in acquiring diphtheria.

Related Conditions

Want to live a healthy lifestyle?

Subscribe to free FactDr newsletters.

REVAMP YOUR

If you're enjoying our website, we promise you'll absolutely love our new posts. Be the first one to get a copy!

Get factually correct, actionable tips delivered straight to your inbox once a week.

I want the latest scoop on :

We hate spam too. We will never share your email address with anyone. If you change your mind later, you can unsubscribe with just one click

By clicking Subscribe, I agree to the FactDr Terms & Conditions & Privacy Policy and understand that I may opt out of FactDr subscriptions at any time.

 

Dos and Don'ts

Dos
  • One time immunization against the disease doesn’t guarantee lifelong protection from the infection. The effect of vaccine wanes with time and one should get routine vaccines once every 10 years.
  • Provide your child the complete DTP vaccine for protection against diphtheria, tetanus, and pertussis (whooping cough).
  • The patient with diphtheria should be kept in isolation for at least the 1st 48 hours after he/she has been administered the antibiotic dose for treating the infection.
Don'ts
  • Consume oily and spicy food In case one gets infected with diphtheria, and include more of fluids and soft foods in the diet.
  • Swallow harmful secretions in the nose and oral cavity; the patient should avoid sleeping on the back.

 

 

 

Related Conditions

Trending Topics

anal sex
Anal Sex : Tips from expert on how to be kinky yet safe Whether it irks you or stokes your fantasies, anal sex has always been an intriguing sexual act. Learn…
diverticulitis diet
Diverticulitis diet: The right way to eat if you suffer from the disease Are you suffering from diverticultis but clueless about your diet ? Read this complete plan for diverticulitis diet…
autoimmune diseases facts
Autoimmune Diseases: Find out if your body is attacking you right now Did you know your body can harm itself? What are autoimmune diseases and why does it harm some…
nature health benefits
Green Healing: The amazing health benefits of being in nature You have no idea what sitting in a closed room does to your body and mind.Can a stroll…
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…
understanding addiction
Addiction explained: An obsession that could cost you your life Is addiction a behavioral disorder? Or is it a chronic disease? How does addiction cause chemical and structural…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
liver detox facts
7 liver detox facts and why ignoring these could kill you! Are you taking care of this organ that handles over 500 different vital functions in your body? Your…
dance health benefits
5 unbelievable effects of dance on your overall health! You enjoy dancing, but did you know what else it does to your body? Dancing is not only…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
GM Diet: The fastest way to lose weight or yet another hoax diet? General Motors started this trend of extreme dieting for 7 straight days to ensure its employees were able…
Creatine: Is this the right peak athletic-performance supplement for you? Creatine is the amino acid that boosts our energy. Did you know creatine supplements can help you reach…
yoga health benefits
How to practice yoga for astounding health benefits Can a 5000-year-old system be the ultimate body healer? Did you know yoga can make you smarter and…
Penis pump: Pump your way out of erectile dysfunction One of the options to treat erectile dysfunction is by the use of a penis pump. It is…
L-arginine: Your search for the ultimate fitness booster ends here L-arginine is an amino acid necessary for the body to perform various functions.  It is essential in producing…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
Pumpkin Seeds: Why pumpkins are more than just for pies! Pumpkins have been long associated with Halloween carvings and delicious pies. But did you know that pumpkin seeds…
How chlorophyll is more than just a green pigment meant for photosynthesis Cholorphyll - you must know the usual function of this chemical in plants. But did you know that…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
Improve sex life
9 best tips from around the world for better sex life How can the pungent-smelling garlic pack in a punch to your libido? How could something as slimy as…
low fodmap plan
Troubled with IBS? Here’s a complete roadmap to the low FODMAP diet Leaky & inflammatory gut troubling you? No medicine bringing you relief from the pain? Why not try the…
How can berberine supplements help you live longer and healthier? Berberine is a turmeric look-alike herbal extract that is credited with numerous health benefits ranging from diabetes cure…
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
eating myths debunked
8 ‘healthy eating’ myths you believed until now Is a zero-carb diet really healthy for you? Are organic products worth their cost? Did you know how…
kefir bottle
Kefir: Top reasons why this probiotic drink should be consumed by you Yet another remarkable fermented food, kefir is a much healthier version of yogurt. These chewy white grains can…
Grapeseed Oil: Find out how to use this oil without any side-effects Grapes are known for their delicious fresh taste and the fact that they make wine a healthy drink.…
carrageenan seaweed
Carrageenan: How a simple seaweed extract could better your gut health & immunity Eat more ice cream to prevent cold and flu? –With carrageenan you get one simple seaweed extract that…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
Agave nectar: The bitter truth about this sweetener revealed Agave nectar is considered to be sweeter than the normal table sugar and even contains higher amounts of…
hYdroxycut pills
Hydroxycut: How safe are these so-called weight loss supplements? Hydroxycut is a blend of several different ingredients formulated to promote weight loss; powered by a key weight…
Maltitol: Things you must know about this artificial sweetener Sugar alcohols are produced by fruits and vegetables. Maltitol is an artificially produced sugar alcohol and is used…
Chlorella: Therapeutic powers of the billion-year-old algae now within your reach Chlorella - A billion year old nutrient-rich algae that can potentially ward off cancers and high cholesterol; the…
Top 15 fat burning foods you need to start eating from today! Tired of going to gym everyday but seeing no change in your weight? Try these top fat burning…
social media adddiction
Your health in the age of Social Media: Why is digital detox a necessity? Did you know that more than 400 million people are dangerously addicted to social media? Are you one…
turmeric skin
We bet you didn’t know that turmeric could be this beneficial! Did you know that turmeric, a humble ingredient found in most Indian kitchens could cure countless ailments and…
tips for perfect sleep
Stop hitting the snooze button: 8 proven steps to perfect sleep Are you tired of not getting enough sleep? All your efforts for a sound sleep going in vain?…
Activated charcoal: The instant health benefits of this “diamond in the coal mine” How can the pitch black activated charcoal help you whiten your teeth? Or have a hangover-free sunday morning?…
Garlic health benefits cloves
Garlic: Nature’s white pill as an effective home remedy What are the secrets hidden in these tiny white pills? Find out the immense health benefits of using…
LDL cholesterol level
Lecithin: Learn how you can utilize this fatty acid to improve your cholesterol count Lecithin is primarily a fatty acid found in common foods such as soy and eggs. However, this fatty…
How cooking with CLA safflower oil can help you lose weight? Read and discover more about CLA safflower oil and how it can aid faster fat metabolism in people…
cancer facts
8 hard-hitting truths no one tells you about cancer Did you know that 1.5 million new cases of cancer are reported every year? Can second-hand smoking kill…
acne removal tips
Anatomy of acne: 7 instant steps to kiss those zits goodbye Blackheads, whiteheads, or pimples-call them what you may. Acne is never good news.Did you know some of the…
Hate making breakfast?Fast and healthy breakfast recipes just for you! Tired of snatching a bagel every morning for breakfast during the rush hour? Here are few fast and…
Bulletproof coffee recipe
Bulletproof Coffee – Breakfast of champions or yet another health fad? Can this special ketogenic coffee really make your body race as fast as a bullet?
paleo keto diet
Paleo vs. Keto: Which diet plan is best suited for your body goals? Is eating like a caveman the right way to go? Can you really eat fats to burn fats…
High Fiber Diet – Fire up your fiber intake for these health benefits! Regular bowels, healthy detox, higher immunity, and guaranteed weight loss - a high fiber diet can bring all…
boost brain health
The ultimate tips on how to boost your brain health Would you like to be smarter? Want a sharp memory but bored of doing sudoku? Try salsa or…
Amaranth: Why is this native Peruvian grain called the “crop of the future”? Full of healthy high proteins and gluten-free, the grain, Amaranth, the tasty and ancient pseudo cereal from Peru,…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
MCT oil athletes
MCT Oil : The kind of fats you should be eating MCT oil or Medium Chain Triglycerides is the new buzzword in the fitness industry. What makes this oil…
castor oil hair
Castor oil : A vitamin-rich oil for shiny locks and healthy bowels Castor oil bestows unlimited benefits, whether you use it for your hair or skin. But did you know…
canola oil cooking
Canola oil: How safe is it to consume this popular cooking oil? Extracted from rapeseeds, Canola oil derives its name from Canadian Oil. Did you know that some forms of…
maltodextrin sugar
Maltodextrin: What are the hidden health benefits of this food additive? Maltodextrin is one of the few food additives that has been relatively deemed safe. Many experts now have…
Moringa drink
Moringa: This could be the most nutrient-dense food known to us! Moringa is a lush green tree brimming with over 90 essential nutrients required for a healthy mind and…
Pomegranate: Why are they called ruby red pearls of health? The shrub Punicagranatum yields a red fruit which is what you normally call pomegranate. The fruit is round…
black seed oil benefits
Black Seed Oil: What secret benefits could it bestow on your health? Black seeds or nigella seeds are tiny packets of health brimming with amazing benefits. Find out why should…
Rick Simpson’s Oil: The truths and controversies of this cannabis product Rick Simpson's Oil is an extract from the much-controversial plant, Cannabis. What is the actual truth behind the…
Anhedonia: Does the chronic inability to feel joy affect you too? How often do you feel dragged down by an invisible force? Do you feel an inexplicable emotional numbness…
Fructose: Healthy fruit-product or loaded with toxic calories? Fructose is a sugar derived from fruits and other plant sources. Does this mean that fructose consumption is…
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…
boost immunity tips
Step up your defence: 15 proven tips on how to boost your immunity Want to naturally build up a stronger immunity? Tired of frequent colds and runny nose?You will never believe…
healthy habits
10 healthy habits: Have a hearty kick-start to the New Year! Do you set goals that are too difficult for you to maintain? Are to struggling to follow healthy…
antibiotic resistance
Antibiotic Resistance: How common diseases become deadly Can a cold kill you? How important is to get a flu shot? Why do antibiotics fail against…
green tea benefits
Green Tea: Does it really aid weight loss and reverse aging? A centuries-old concoction of fresh green leaves, green tea holds the secret to healthy weight loss & delayed…
global warming health
Rising mercury and your health: How Global Warming is damaging your body Don't ignore the rising temperature. Global warming causes more than just heat strokes. It could be a lot…
Milk Thistle skin
Milk Thistle: Find possible cures for fatal diseases in these purple blooms Milk thistle is well-known for treating liver conditions. However, did you know that it comes with a plethora…
iron food shellfish
Iron-Rich Foods: Eat these foods to keep fatigue and anemia away! How to ensure a muscles as strong as iron? Eat iron rich foods ! Iron is one of…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
gout diet purines
Gout Diet : Get relief from painful joints by eating these foods Are you a victim of this painful condition? Are medications providing only short relief? Find a list of…
Juice Plus: Can you really replace actual fruits with pills?  Juice Plus supplements intend to fill nutritional gaps present in our daily diet. But how successful have they…
Did you know drinking alkaline water could be the healthier choice for you? Ever wondered how safe is your drinking water in terms of pH? Recent studies have revealed that Alkaline…
Amnesia brain
Amnesia: It’s not just a blow on the head that can erase your memory Amnesia, a condition popularized by many a tv shows, is a condition of partial or permanent memory loss.…
stress adverse effects
Fight, flight, or freeze: 8 ways stress can ruin your body Did you know that stress is in-built in our systems? It helped our ancestors respond to danger. How…