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Diphtheria

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Diphtheria (pronounced dif-THEER-ee-a) was a major cause of illness and death among children. This disease is caused by the bacterium Corynedbacterium diphtheriae. In 1921, there were 206,000 cases of diphtheria that led to 15,520 deaths. Afterward the rates began to drop when vaccination started. Over the past decade, there were less than five cases of diphtheria in the U.S. that were reported to CDC. The disease continues to play a role globally—In 2011, 4,887 cases of diphtheria were reported to the World Health Organization (WHO), but there are likely many more cases that go unreported.

  • Transmission and Symptoms
  • Diagnosis and Treatment
  • Vaccine
  • Complications and Side Effects

Transmission

Diphtheria transmission is possible through spreading from one person to another. If a person coughs or sneezes they can spread germs. It is rarely spread from skin sores or clothes in contact with a person with diphtheria. A person can get infected from coming in contact with an object, such as a toy, that is contaminated.

Symptoms

  • Weakness
  • Sore throat
  • Fever
  • Swollen glands in the neck
  • 2-3 days later, a thick, gray coating can build up in the throat or neck making it difficult to breathe and swallow

In determining if a person has diphtheria it is key to look for signs and symptoms of the disease. If diphtheria is suspected, one should visit the hospital immediately. A swab specimen will be taken from the throat to test for the bacteria. A sample can also be taken from a skin lesion for testing. Once the proper diagnosis is made, treatment involves a diphtheria antitoxin to counteract the toxin that is produced by the bacteria. Antibiotics are used to kill and eliminate diphtheria bacteria. Patients are generally isolated for 48 hours after antibiotic treatment begins. After this point the bacteria is not able to spread.

Vaccination is the best way to prevent diphtheria. There are four different combination vaccines that can be used to prevent diphtheria; DTaP, Tdap, DT, and Td. DTaP and Tdap also prevent pertussis (whooping cough). DTaP and DT vaccines are given to children that are younger than seven years of age. Tdap and Td vaccines are given to older children, teens, and adults.

Upper-case letters in these abbreviations denote full-strength doses of diphtheria (D) and tetanus (T) toxoids and pertussis (P) vaccine. Lower-case “d” and “p” denote reduced doses of diphtheria and pertussis used in the adolescent/adult-formulations. The “a” in DTaP and Tdap stands for “acellular," meaning that the pertussis component contains only a part of the pertussis organism. DTaP stands for Diphtheria-Tetanus-acellular Pertussis vaccine. DT stands for Pediatric-Diphtheria-Tetanus vaccine. Td stands for Tetanus-diphtheria vaccine. Tdap stands for Tetanus-diphtheria-acellular Pertussis.

Disease Complications

As the disease gets worse it can have more pronounced complications on the body. It can block the airway, can damage heart muscles, cause nerve damage and even paralysis. Lung infections are also a possibility and ultimately death is possible. This is why knowing about this disease and getting vaccinated is important.

Risk of Side Effects

There is a chance of side effects, these are usually mild and go away on their own. Serious reactions are also possible but are rare and most people who get the Td vaccine will not have problems. Possible mild problems will not interfere with your regular activities. Mild symptoms are pain where the shot was given (8 in 10). Redness or swelling where the shot was given (1 in 4). A mild fever, which is rare. Headaches (about 1 in 4) and tiredness (1 in 4) are also a possibility. Moderate problems interfere with activities, but do not require medical attention. They can include a fever over 102F. Those with severe problems who are unable to perform usual activities and require medical attention will usually deal with swelling, severe pain, bleeding and/or redness in the arm where the shot was given.

What if there is a serious reaction?

Signs of a severe allergic reaction such as a very high fever or unusual behavior, hives, swelling of the face and throat, difficulty breathing, fast heartbeat, dizziness and weaknesses. If a reaction is suspected call 911 or go to the nearest hospital immediately.