Diptheria - swheal

CONDITIONS

Diphtheria

A serious bacterial infection affecting the mucous membranes of the nose and throat is known as diphtheria. Diphtheria is a highly contagious disease, one that is also treatable with medicines and preventable with vaccines. Around 78% of globally reported cases of diphtheria are reported from India with significant mortality despite national programs. In 2022, diphtheria cases for India were 3,286. Although with high fluctuations in recent years, the cases in India showed a decreasing trend through 2003 – 2022. Even with treatment, diphtheria can be deadly, especially in children if not treated in timely manner.

What are the symptoms of diphtheria?

Typically, symptom occurrence might occur 2-5 days post exposure of the infection while the length of the symptom can be anywhere between 1 to 10 days. Common diphtheria symptoms include:

Sore throat and sometime throat pain.
Weakness or fatigue.
Fever.
Swollen neck glands.
Difficulty in breathing.
Difficulty swallowing (dysphagia).
Nasal discharge
Fever and chills
Nerve, kidney or heart problems (if the bacteria enters your bloodstream).

One type of bacteria is the skin (cutaneous) diphtheria that causes causing pain, redness and swelling at the skin. Sometimes, ulcers with grey membrane may also be seen. Skin diphtheria generally occurs because of poor hygiene.

What are the causes of diphtheria?

Caused by the bacteria Corynebacterium diphtheriae, diphtheria usually spreads when the bacteria multiply on or near the surface of the throat or skin spreading by:

When a person coughs or sneezes via the droplets discharged into the air and breathed into the lungs of a nearby person.
Contaminated personal or household items such as towels.

Who is at risk of diphtheria?

Diphteria hardly occurs in developed countries where vaccinations have been given since decades. However, following people may be more prone to getting infections:

Children and adults with latest vaccinations
People living in crowded or unsanitary conditions
Person traveling to an area with diphtheria infections.

How is diphtheria diagnosed?

An unwell child with sore throat and a grey membrane covering the tonsils and throat is suspected of diphtheria. Diagnosis is confirmed by a lab culture of material from the throat. Immediate treatment is necessary if doctor suspects diphtheria.

How is diphtheria treated?

Treatment includes using diphtheria antitoxin to stop the bacteria toxin from damaging the body. This treatment may be used for skin diphtheria but is vital for respiratory diphtheria.
Antibiotics are prescribed to kill the bacteria in both cases – skin and respiratory.

People with diphtheria usually do not transmit infection 48 hours post antibiotics. However, completing the course of antibiotics is necessary for complete eradication of the bacteria from the body. A post treatment test may be advised by the doctor to check for presence of bacteria.

How can diphtheria be prevented?

Best way to prevent diphtheria is with a vaccine which is often given in combination with diphtheria and tetanus (DPT). Generally, five vaccines are given to children over course of time. These are at age 2 months, 4 months, 6 months, 15 to 18 months and 4 to 6 years. Booster shots may be given to some adults prone to infections, pregnant females and adolescents.

Are there any programs in India?

The Government of India launched “Mission Indradhanush” to strengthen the immunization programme and to rapidly achieve full immunization coverage of all children and pregnant women against seven vaccine preventable diseases including diphtheria. This mission includes reaching out in schools, slums, high risk areas and conducting vaccination drives to achieve more than 90% full immunization coverage in India.

References

Gupta, Akshita; Gujral, Meher; Singh, Ajay; Chawla, Kiran. Diphtheria resurgence in India: A case study from south Karnataka. Journal of Family Medicine and Primary Care, November 2020; 9(11):p 5776-5778.
Diphtheria. Mayo Clinic. January 2024. https://www.mayoclinic.org/diseases-conditions/diphtheria/diagnosis-treatment/drc-20351903
Diphtheria. Cleveland Clinic. January 2024. https://my.clevelandclinic.org/health/diseases/17870-diphtheria
Devanga Ragupathi NK, Muthuirulandi Sethuvel DP, Murugan D, Ranjan R, Gautam V, Gupta P, et al. (2021) Divergent evolution of Corynebacterium diphtheriae in India: An update from National Diphtheria Surveillance network. PLoS ONE 16(12): e0261435.

Mumbai