Diphtheria

Where it occurs

Although once widely prevalent, in recent years diphtheria has been confined to Russia, former states of the old Soviet Union, Africa and Asia.

Infection

Diphtheria is caused by a bacterium called corynebacterium diphtheria which releases a toxin into the body. Infection is spread from person to person through infected droplets of saliva propelled by coughing and sneezing. The bacteria multiply in the respiratory tract, including the throat, nose, tonsils, pharynx and larynx, and occasionally also the skin.

The toxin destroys the mucous membrane lining the respiratory tract giving rise to serious inflammation. The membrane can become detached creating an obstruction which makes breathing difficult and can lead to asphyxiation. Also, the toxin, can travel to other parts of the body causing damage to the cardiac muscle and nervous system.

Symptoms

These usually appear two to five days after infection. Initial symptoms usually include a sore throat, coughing and difficulty in breathing. If the illness affects the skin, crusty scabs may appear. Sufferers commonly experience a rise in their temperature, weakness and fatigue. In the worst cases, there the heart and nervous system are affected, sufferers may experience local paralysis, an irregular heartbeat and/or a heart attack.

Treatment

Sufferers should go immediately to hospital as the disease can develop rapidly and the mortality rate is high. Treatment is by anti-toxins if there isn’t time to wait for the results of diagnostic tests and then with antibiotics. Artificial ventilation may be required.