Diphtheria is a serious upper respiratory tract bacterial infection, usually affecting the mucous membranes of your nose and throat. Diphtheria is caused by Corynebacterium diphtheriae. Diphtheria is a bacterial infection that spreads easily and occurs quickly. Diphtheria is highly contagious. It’s easily passed from the infected person to others through sneezing, coughing, or even laughing. It can also be spread to others who pick up tissues or drinking glasses that have been used by the infected person.
In advanced stages, diphtheria can cause damage to your heart, kidneys and nervous system. Even with treatment, diphtheria can be deadly — between 5 and 10 percent of people who get diphtheria die of it.
Preventing diphtheria depends almost completely on immunizing children with the diphtheria/tetanus/pertussis vaccine and non-immunized adults with the diphtheria/tetanus vaccine. Most cases of diphtheria occur in people who haven’t received the vaccine at all or haven’t received the entire course.
Diphtheria spreads through respiratory droplets of an infected person or someone who carries the bacteria but has no symptoms. Diphtheria can also be spread by contaminated objects or foods such as contaminated milk.
The bacteria most commonly infects the nose and throat. The throat infection causes a gray-to-black, tough, fiber-like covering, which can block the airways. In some cases, diphtheria may first infect the skin, producing skin lesions.
Diphtheria typically causes a sore throat, fever, swollen glands and weakness. But the hallmark sign is a thick, gray covering in the back of your throat that can make breathing difficult.
Signs and symptoms of diphtheria usually begin two to five days after a person becomes infected and may include:
- A sore throat and hoarseness
- Painful swallowing
- Swollen glands (enlarged lymph nodes) in your neck
- A thick, gray membrane covering your throat and tonsils
- Difficulty breathing or rapid breathing
- Nasal discharge
- Fever and chills
Doctors confirm the diagnosis by taking a sample of the membrane from the child’s throat with a swab and having the sample grown (cultured) in a laboratory. Your doctor should notify the laboratory that diphtheria is suspected. Doctors can also take a sample of tissue from an infected wound and have it tested in a laboratory, to check for the type of diphtheria that affects the skin
If a doctor suspects diphtheria, treatment begins immediately, even before the results of bacterial tests are available.
Diphtheria anti-toxin is given as a shot into a muscle or through an intravenous line. The infection is then treated with antibiotics, such as penicillin or erythromycin. Antibiotics help kill bacteria in the body, clearing up infections. Antibiotics reduce to just a few days the length of time that a person with diphtheria is contagious. The antitoxin neutralizes the diphtheria toxin already circulating in your body. Doctors accomplish this by initially giving small doses of the antitoxin and then gradually increasing the dosage.
People with diphtheria may need to stay in the hospital while the anti-toxin is being received. Other treatment may include:
- Fluids by IV
- Bed rest
- Heart monitoring
- Insertion of a breathing tube
- Correction of airway blockages
Anyone who has come into contact with the infected person should receive an immunization or booster shots against diphtheria. Protective immunity lasts only 10 years from the time of vaccination, so it is important for adults to get a booster of tetanus-diphtheria (Td) vaccine every 10 years.
Those without symptoms but who carry diphtheria should be treated with antibiotics.
A person with diphtheria must be isolated. Family members (as well as others who spend a lot of time with the person with diphtheria) who haven’t been immunized, or who are very young or elderly, must be protected from contact with the patient.