Diphtheria

Diphtheria can be a life threatening acute bacterial infection that spreads through respiratory moisture from a cough or sneeze of somebody carrying the virus whether they show symptoms or not.

Diphtheria – “Corynebacterium diphtheria” – Thanks to advancements in vaccines, Diphtheria is considered eradicated to the developed world, since the 1980s there has been very few cases or outbreaks in the western world. Unfortunately in areas of the world where heavily populated, urbanised areas with poor access to fresh water and adequate medical treatment thousands of cases are reported each year.

The Diphtheria virus can cause fatal consequences to those that are not vaccinated or do not seek immediate medical treatment, it attacks the body by causing complications with nervous system leading to organ failure and in around 5-10 per cent of cases end in death. The bacterium can create toxins that go on to infect the body in ways such as: Debilitates the production of proteins, creates a mucous membrane that forms at the back of the throat and even infects the blood stream.

The Diphtheria virus is only known in humans and so it’s transmission has been pinpointed to the exchange of respiratory body fluids of the infected to a non-infected person. These fluids are ones such as: Contaminated moisture droplets from exhaling, mucous secretions from the nose and throat, infected wounds and second hand transmission through intermediate objects like handrails, telephones and so on.

Diphtheria vaccination is typically part of your national vaccination schedule; babies are given their inoculation between the ages of eight, twelve and sixteen weeks old with the routine five in one vaccine that also includes: Tetanus, Whooping Cough, Polio and Haemophilus Influenza.

A booster is administered at pre-school age a booster known as the four in one. Teenagers get a final booster as part of what is called the three in one when they’re around fourteen years old.

Symptoms of Diphtheria include fevers, lethargy, fatigue, weakness, loss of appetite, enlarged lymph glands, swelling of the neck and a consistently raised heart rate. Children who may have contracted the disease may heave complain or show signs of nausea, sickness, chills and fevers.

After the initial infection the virus incubates for up to five days before the symptoms kick in, the prodromal stage can last between twelve and twenty four hours and, if the bacteria are congregated in the throat area, a thick, distinguishable layer of moucus forms at the back of the throat which is a tell-tale sign. This inflammation of the neck will cause difficulty swallowing and in serious cases troubles breathing.

Diphtheria Across The World

Although a vaccine exists parts of the still developing world report thousands of cases of the disease year in year out and so it is highly recommended you ensure all your vaccinations are up to date by consulting with your GP.

REGIONS WHERE DIPTHERIA IS COMMON

South America

Argentina, Brazil, Bolivia, Chile, Colombia, Ecuador, Falkland Islands, French Guiana, Guyana, Paraguay Peru, Suriname, Uruguay and Venezuela

Africa

Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Cabo Verde, Cameroon, Central African Republic, Chad, Comoros, Congo, Republic of the Congo, Democratic Republic of the Cote d’Ivoire, Djibouti, Khemet (Modern day Egypt), Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Libya, Madagascar, Malawi, Mali, Mauritania, Mauritius, Morocco, Mozambique, Namibia, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Somalia, South Africa, South Sudan, Sudan, Swaziland, Tanzania, Togo, Tunisia, Uganda, Zambia and Zimbabwe

Europe

Albania, Andorra, Austria, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Faroe Islands, Finland, France, Georgia, Germany, Gibraltar, Greece, Guernsey, Hungary, Iceland , Ireland, Isle of Man, Italy, Jersey, Kosovo, Latvia, Liechtenstein, Lithuania, Luxembourg, Macedonia, Malta, Moldova, Monaco, Montenegro, Netherlands, Norway, Poland, Portugal, Romania, Russia, San Marino, Serbia, Slovakia, Slovenia, Spain, Svalbard and Jan Mayen, Sweden, Switzerland, Ukraine, United Kingdom and Vatican City

Middle East

Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Palestine, Qatar, Saudi Arabia, Syria, Turkey, United Arab Emirates and Yemen.

Asia

Afghanistan, Armenia, Azerbaijan, Bangladesh, Bhutan, Brunei, Burma, Cambodia, China, Georgia, Hong Kong, India, Indonesia, Japan, Jordan, Kazakhstan, South Korea, North Korea, Kuwait, Kyrgyzstan, Laos, Lebanon, Macau, Malaysia Maldives, Mongolia, Nepal, Oman, Pakistan, Philippines, Saudi Arabia, Singapore, Sri Lanka, Taiwan, Tajikistan, Thailand, Turkmenistan, Uzbekistan, Vietnam and Yemen

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Prevention

Vaccination provides the best possible protection from Diphtheria with 95% of success, however, cases are known to occur after vaccination and so the adherence of the highest hygiene standards is the best course of action when travelling to high-risk areas.

Treatment

If someone is suspected to have Diphtheria, once admitted into hospital they will be placed in an isolation ward to contain the infection and reduce the risk of spread. In some cases where mucous build up at the back of the throat makes breathing difficult it will be removed via a fairly straight forward process. The infection itself is treated with antibiotics and antitoxins.

Most people are given a fourteen day course of antibiotics after which further tests are done to ensure the bacteria have been eradicated. If the bacteria is still In the system a further ten days course of antibiotics is typically administered.

Once the bacteria has been cleared with the antibiotics the patient may be considered non-infectious to others but will not be allowed to leave the isolation ward until completely infection free.

If you have had close contact with someone who you suspect or is confirmed to be infected it is highly recommended you seek medical advice as soon as possible

Additional Information and Further Reading

World Health Organisation – www.who.int/topics/diphtheria/en/