by Kimberly Allen RN
Diptheria is a very serious bacterial infection. It usually affects the respiratory system but can also affect the skin. Diptheria is a deadly disease with fatality rates as high as 20% in young children and adults over 40 years of age. Since the vaccine became available the incidence of diptheria has significantly declined, however there are still severe outbreaks of the disease worldwide including in developed countries. Experts have noticed an increase in incidence in recent years as parent have opted not to have their children vaccinated.
Diptheria is caused by a bacteria called corynebacterium diptheria. The bacteria spreads like a virus through the tiny moisture droplets that are expelled into the air when an infected person coughs or sneezes. These droplets can be inhaled by other people near the infected person. they can also land on surfaces like door knobs and toys to name a few. Then people, especially children, touch those contaminated surfaces with their hands and then from their hands it gets into their eyes, noses and mouths etc. Sharing drinking glasses and other utensils is another common way the infection spreads.
Diptheria is a serious disease that can lead to serious complications. The bacteria that causes diptheria usually releases a toxin that damages the tissues in the area of the infection which is usually the nose and throat. The infection then produces a thick membrane of dead cells that can impair breathing. The toxin is also capable of traveling through your bloodstream causing damage to other areas including your heart. The toxins can cause damage that ranges from a mild inflammation of the heart muscle to severe congestive heart failure and death. In addition the toxins can also damage the nerves. Usually the toxins target the nerves to the throat. Damage to these nerves causes difficulty with swallowing. The toxins also travel and affect other areas of the body like the nerves that control breathing. Damage to these nerves paralyzes the respiratory muscles making it impossible to breathe without mechanical assistance.
The symptoms of diptheria usually manifest anywhere from 2-5days after being exposed ti the bacteria. The symptoms usually start with a sore throat and fever as well as a feeling of malaise, in other words you just don’t feel good, not bad, but not good. As the infection progresses there will be a hoarseness and difficulty swallowing, and frequently difficulty breathing.
Diptheria requires immediate and aggressive treatment. The first thing the Dr will do is after confirming the diagnosis is administer the antitoxin. The antitoxin is then able to neutralize the toxins. Then the Dr will administer antibiotics to kill the bacteria which reduces the length of time that the diptheria patient is contagious. Treatment for diptheria is intense and requires hospitalization, usually under isolation precautions in the intensive care unit.
The best way to prevent diptheria is through vaccination. Currently the diptheria vaccine is given in combination with tetanus and pertussis known as the DTaP vaccine. The vaccination series is 5 separate injections given at 2months, 4months, 6months and 12-18months then at 4-6years old. There have been rare cases of an allergic reation like hives or a rash at the injection site as well as more serious complications like seizures or even shock all of which are treatable. These are very rare complications that can occur with any medication, it is still better to get the vaccine before getting the disease instead of after.