Diphtheria

 

• Diphtheria is a very contagious and potentially life-threatening bacterial disease.
• Diphtheria usually attacks the throat and nose. In more serious cases, it can attack the heart and nerves.
• Because of widespread immunization, diphtheria is very rare in the United States.
• Diphtheria is re-emerging in some areas of the world where immunization practices are lax. Routine vaccination of both children and adults is essential to prevent the re-emergence of diphtheria in the United States.

 

What is diphtheria?

Diphtheria is a very contagious and potentially life-threatening infection that usually attacks the throat and nose. In more serious cases, it can attack the nerves and heart. Because of widespread immunization, diphtheria is very rare in the United States. However, some people are not adequately vaccinated, and cases still occur.

 

What is the infectious agent that causes diphtheria?

Diphtheria is caused by Corynebacterium diphtheriae, a bacterium. The bacterium produces a toxin (poison) that is carried in the bloodstream.

 

Where is diphtheria found?

Diphtheria is common in many parts of the world. Diphtheria bacteria live in the mouth, nose, throat, or skin of infected persons.

 

How do people get diphtheria?

Diphtheria spreads from person to person very easily. People get diphtheria by breathing in diphtheria bacteria after an infected person has coughed or sneezed. People also get diphtheria from close contact with discharges from an infected person's mouth, nose, throat, or skin.

 

What are the signs and symptoms of diphtheria?

Usually, diphtheria develops in the throat. Early symptoms are a sore throat and mild fever. A membrane that forms over the throat and tonsils can make it hard to swallow. The infection also causes the lymph glands and tissue on both sides of the neck to swell to an unusually large size.

Some people can be infected but not appear ill. They can also spread the infection.

 

How soon after exposure do symptoms appear?

Symptoms usually appear 2 to 4 days after infection.

 

How is diphtheria diagnosed?

Diagnosis is by physician examination and throat culture.

 

Who is at risk for diphtheria?

Diphtheria is most common in areas where people live in crowded conditions with poor sanitation. Persons, especially children, who are not immunized or who did not receive adequate immunization are most at risk.

 

What complications can result from diphtheria?

If diphtheria is not properly treated, or not treated in time, the bacteria can produce a powerful toxin (poison). This poison can spread through the body and cause serious, often life-threatening complications. The diphtheria toxin can damage the heart muscles and cause heart failure or paralyze the breathing muscles. The membrane that forms over the tonsils can also move deeper into the throat and block the airway.

 

What is the treatment for diphtheria?

Diphtheria is a medical emergency. A delay in treatment can result in death or long-term heart disease. A person with diphtheria should be hospitalized until fully recovered. The person should be given a medicine (diphtheria antitoxin) to fight the diphtheria poison and antibiotics to fight the diphtheria bacteria. Some patients might need mechanical help in breathing (respirator).

Persons who have been in close contact with the patient should have throat cultures and be given antibiotics. They should be closely watched for possible symptoms. Close contacts who have not been immunized should receive a complete series of diphtheria shots. A booster vaccine can be given to persons who have been immunized before.

 

How common is diphtheria?

Diphtheria was once one of the most common causes of death in children. Since the introduction and widespread use of diphtheria vaccine, diphtheria has been rare in the United States. Between 1980 and 1995, 41 cases of diphtheria were reported to health authorities.

Diphtheria is still common in many other parts of the world, including the Caribbean and Latin America. During the last few years, large epidemics of diphtheria have occurred in the former Soviet republics. Outbreaks have also been reported in Algeria, China, and Ecuador. The majority of cases in many of these epidemics have been in adults and adolescents.

 

Is diphtheria an emerging infectious disease?

Yes. Diphtheria has re-emerged in the newly independent states of the former Soviet Union and in some other parts of the world at near-epidemic levels. The increases have generally been the result of failed public health and immunization programs in areas weakened by economic and social turmoil.

In the United States, the diphtheria threat is shifting from children to adults and adolescents. Cases are occurring in persons who have not been immunized or in vaccinated persons who did not receive periodic booster doses to maintain their immunity. Routine vaccination of both children and adults is essential to prevent the re-emergence of diphtheria in the United States.

 

How can diphtheria be prevented?

There is a vaccine for diphtheria. The diphtheria vaccine is usually given in a combination shot with tetanus and pertussis vaccines, known as DTP vaccine. A child should have received four DTP shots by 18 months of age, with a booster shot at age 4 years to 6 years. After that, diphtheria and tetanus boosters should be given every 10 years to provide continued protection.

As is the case with all immunizations, there are important exceptions and special circumstances. Health-care providers should have the most current information on recommendations about diphtheria vaccination.

 

This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health-care provider. If you have any questions about the disease described above, consult a health-care provider.