What is Diphtheria?
Diphtheria is a contagious disease that can be spread through coughing, sneezing, or open wounds. Symptoms include a sore throat and breathing problems.
The main cause of diphtheria is infection with the bacteria Corynebacterium diphtheriae which attacks the mucous membranes of the nose and throat and can affect skin conditions.
The disease can affect people of all ages and carries the risk of serious, potentially life-threatening infections. Treatment includes antibiotics and antitoxins to kill the bacteria.
One of the most effective steps to prevent diphtheria is to get vaccinated against diphtheria.
Symptoms of Diphtheria
Generally, symptoms of diphtheria will appear 2–5 days after someone is infected with the bacteria Corynebacterium diphtheriae. After that, the bacteria spreads to the bloodstream and causes the following symptoms:
- The formation of a thin, gray layer that covers the tonsils and throat.
- Fever and chills.
- Sore throat and hoarse voice.
- Difficulty breathing or rapid breathing.
- Swollen lymph nodes in the neck.
- Weak and tired.
- A runny nose that is initially runny, but can be mixed with blood.
- A violent cough.
- Feeling uncomfortable.
- Visual disturbances.
- Talking ramblingly.
- Signs of shock, such as pale, cold skin, sweating, and a fast heartbeat.
In some people, the disease is mild or there are no obvious signs and symptoms at all. In such cases, they remain unaware of their illness and can still potentially transmit it to others.
Causes of Diphtheria
Diphtheria is caused by infection with the bacteria Corynebacterium diphtheriae. This infection can be transmitted through airborne particles, personal objects, contaminated household equipment, and touching wounds infected with diphtheria germs.
In addition, diphtheria can also be transmitted through a person’s saliva. Even if an infected person does not show signs or symptoms of diphtheria, they can still transmit the bacteria for up to six weeks after the initial infection.
Bacteria most often infect the nose and throat. After infecting, the bacteria release harmful substances called toxins that then spread through the bloodstream and cause a thick gray coating.
This layer usually forms in the nose, throat, tongue and airways. In some cases, this toxin can also damage other organs, including the heart, brain and kidneys, potentially causing life-threatening complications.
Risk Factors for Diphtheria
The risk of diphtheria transmission increases in people who have not been vaccinated. Other factors that can increase the risk of transmission include:
- Visiting areas with low diphtheria immunization coverage.
- Weak immune system, such as those with HIV/AIDS.
- Unhealthy lifestyle.
- Environment with poor hygiene and sanitation.
- Children under 5 years of age and adults over 60 years of age.
- Living in a densely populated settlement.
- Traveling to areas with high cases of this disease.
Diphtheria Diagnosis
The doctor will diagnose diphtheria by conducting a medical interview, a physical examination to see the gray layer on the tonsils or in the throat and enlarged lymph nodes in the neck.
If a gray coating is found in the throat area, the doctor may need to take a tissue sample for further examination in the laboratory.
Diphtheria Treatment
Diphtheria is a potentially fatal disease, so it needs to be treated as soon as possible and aggressively. In the early stages, doctors need to make sure the airway is not blocked or obstructed.
In some cases, doctors need to place a breathing tube in the throat to keep the airway open until the inflammation in the airway subsides.
After that, the doctor will focus on eradicating the bacteria that cause diphtheria by providing the following treatments:
- Antibiotics. Giving antibiotics, such as penicillin or erythromycin, can help kill the bacteria and clear up the infection. Antibiotics can also prevent the spread of diphtheria from someone with the disease to others.
- Antitoxin. The doctor will also give medication to neutralize the diphtheria toxin in the body (antitoxin). This medication is given by injection into a vein or muscle. Before giving antitoxin, the doctor needs to do a skin allergy test to make sure the infected person is not allergic to the antitoxin. If someone has an allergy, the doctor will most likely not give antitoxin and will look for other alternative treatments.
Children and adults with diphtheria often need to be hospitalized and isolated in an intensive care unit.
This is because diphtheria can spread easily to anyone who is not vaccinated against the disease.
Complications of Diphtheria
Most cases of diphtheria cause significant symptoms and need to be treated to prevent life-threatening complications. If left untreated, the disease can cause:
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Respiratory problems.
The bacteria that cause diphtheria can produce a toxin or poison. This poison can damage tissue in the area of infection, usually in the nose and throat.
In this area, the infection produces a gray layer of dead cells, bacteria, and other substances. If left untreated, this membrane can block breathing.
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Heart damage.
The toxins produced by the bacteria also risk spreading through the bloodstream and damaging other tissues in the body. For example, it can damage the heart muscle, causing complications such as inflammation of the heart muscle (myocarditis).
Heart damage from myocarditis can range from mild to severe. In the most severe cases, myocarditis can lead to heart failure and sudden death.
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Nerve damage.
The poison can also cause nerve damage in the throat. Nerves that are affected can cause difficulty swallowing. The poison can also affect the nerves in the arms and legs and cause muscle weakness.
When the toxin damages the nerves that control the respiratory muscles, these muscles can become paralyzed and the sufferer is at risk of respiratory failure.
With treatment, people with diphtheria have a chance of surviving these complications, although recovery takes a long time. About 5-10 percent of cases of this disease are fatal and the death rate is higher in children under 5 years of age or the elderly.
Diphtheria Prevention
The only effective prevention of diphtheria is to get a diphtheria vaccination. In Indonesia, the diphtheria vaccine is one of the mandatory vaccinations for toddlers. Diphtheria vaccination is generally combined with tetanus and whooping cough (pertussis) vaccines.
Well, this vaccine is better known as the DPT (Diphtheria, Tetanus, Pertussis) immunization.
DPT immunization is given five times when children are 2 months, 3 months, 4 months, 18 months, and 4–6 years old. After this, children need to get a booster given through Td or Tdap immunization for children over 7 years old and must be repeated every 10 years, including for adults.
So, When is the Right Time to Give the Diphtheria Vaccine?
In addition to getting vaccinated, environmental cleanliness also needs to be considered, especially in densely populated settlements and areas with poor sanitation.
If you experience symptoms of diphtheria, do not delay in seeing a doctor to get the right diagnosis.
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- Myth or Fact: Unvaccinated People Are at Risk of Getting Diphtheria
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