Diphtheria

Diphtheria is a bacterial disease that typically affects the mucous membranes along the respiratory tract with the mostly recorded mortality cases attributable to asphyxia or myocarditis. The infection is repeatedly mistaken as a mere bad sore throat. Over time, the patient may have breathing difficulty and may go into shock. ^{[1] [2] [3]}

Epidemiology

Vaccination has greatly helped in decreasing the rates in several areas around the globe although the disease remains a health threat in developing countries. Death rates have not changed significantly over the past years.

No racial predilection is known. The incidence is the same on both genders however mortality in endemic areas is more common among female infants and children.  The disease primarily affects children but due to vaccination, the rates were greatly diminished however new cases are now being recorded among adolescent and adults.  ^[2]

Causes

The causative organism is Corynebacterium diphtheria. The organism can be spread thru airborne droplets such as when an affected person coughs or sneezes or by having contact with contaminated items. ^[4]

Risk factors include living in congested areas, incomplete immunization, low immune status and poor quality living conditions.  ^[1]

Signs and Symptoms

Affected people initially have symptoms that mimic an upper respiratory tract infection. Frequent manifestations are sore throat, low grade fever, chills, weakness, ill-feeling, headache, hoarseness, cough, enlarged glands along the neck and shortness of breath. ^[1] The poison produced by the bacteria may cause paralysis or in some cases, heart failure.^[5] One type of diphtheria is called cutaneous diphtheria which is more frequent in tropical regions and may manifest as pain, redness, ulceration and swelling in the skin. ^[4]  

Diagnosis

After getting the patient’s medical history, a physical examination is done. The disease is frequently suspected when upon inspection of the mouth, gray membrane covering of the tonsils and throat is observed. To confirm the diagnosis, culture is needed. ^[4]

Treatment

Antitoxin and antibiotics are often given. Isolation of patient is often required since the disease is communicable.

Prevention

The vaccine can prevent the disease however it wanes over time thus boosters are indispensable. ^[5]

References:

1.      http://emedicine.medscape.com/article/782051-overview

2.      http://www.onhealth.com/diphtheria/article.htm

3.      http://kidshealth.org/parent/infections/bacterial_viral/diphtheria.html

4.      http://www.mayoclinic.com/health/diphtheria/DS00495/DSECTION=causes

5.      http://www.nlm.nih.gov/medlineplus/diphtheria.html