Diphtheria is a bacterial infection of the nose and throat that is highly contagious and particularly dangerous for children under five years old. Children who are not vaccinated at the appropriate time, are malnourished and/or who live in crowded, unsanitary conditions are particularly at risk for contracting diphtheria.
At the onset of the disease, diphtheria feels like a particularly bad sore throat that is often accompanied by fever or swollen glands in the neck. As the disease proceeds, the bacterial infection grows in the form of a fuzzy, dark-coloured, membranous coating in the airway. The coating can cause difficulty breathing and swallowing for the patient. As the infection progresses, the patient may complain of double vision, have slurred speech, and in severe cases display signs of shock, including pale, cold skin, rapid heartbeat and cold sweat.
If left untreated, the diphtheria toxin will spread through the bloodstream and can cause serious complications in major organs. It can disrupt heart and kidney function, and eventually cause nerve damage that can lead to paralysis. As many as fifty percent of diphtheria patients who do not receive treatment die. Diphtheria is highly contagious, and can be passed on by contact through sneezing and coughing. Persons who are infected but not showing any symptoms may be contagious for up to four weeks.
Prevention of diphtheria is dependent on vaccination. The diphtheria/tetanus/pertussis (DTP) vaccine should be administered to all children and non-immunized adults. Adolescents and adults should receive a booster shot every ten years, although the majority of cases occur in those people who have never received the initial vaccine. The vaccine should also be administered to pregnant women during the second half of their pregnancy regardless of when they last had the vaccine or booster. The majority of recipients tolerate the vaccine with no side effects, although occasionally there are mild reactions including tenderness and redness at the injection site or mild fever.
Patients with diphtheria must be immediately isolated and taken to a hospital for treatment. People who have not been vaccinated, those under five years old, or over sixty should all be protected from coming into contact with the patient.
Once a physician confirms diphtheria infection via throat culture, the patient is administered an anti-toxin either intravenously or through injections. This agent neutralizes the effects of any diphtheria toxin already present in the bloodstream. Additionally the patient is treated with antibiotics to eradicate the diphtheria bacteria. Advanced cases may require the patient be placed on a ventilator to assist with breathing. In cases where the major organs such as the kidneys, heart, or nervous system are affected, additional medications, IV fluids, and oxygen may be necessary.
Everyone in a household who has been exposed to a diphtheria patient must be treated with boosters of the vaccine, immune status assessment, and throat cultures that determine whether they have been infected. Prophylactic antibiotics will also be administered.
If a patient is immediately hospitalized and the infection is caught early enough, they have a high likelihood of recovery. Once antibiotics and anti-toxin medications are working, they will need bed rest for approximately four to six weeks in order to fully recover. Complications of diphtheria, such as myocarditis or kidney failure, will require further treatment to ensure full recovery.
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