It is an acute infectious and communicable disease caused by respiratory system. The micro-organism of this disease attacks the tonsils, trachea, nasal passage, sound box and secretes a false membrane of serotoxin causing inflammation.
In severe conditions this membrane spreads in the air passage, blocks the entry of the air, and causes difficulty in breathing. It may even cause choking if timely medical aid is not given. Generally restricted to the children of 6 months 5 years age group, it may occur up to the age of 15 years. Winter is the most usual season for diphtheria.
Infection with the diphtheria bacillus, of which there are several strains, the Gravis strain being the most serious. Other two strains are:
(a) C. Diphtheria Intermedius.
(b) C. Diphtheria Mitis.
(a) Direct contact mainly through the carriers, whether sick or healthy. Nasal carriers are more dangerous than throat carriers.
(b) Indirect transmission through infected articles, such as, clothes, toys, utensils, infected pencils, etc.
(c) Consuming contaminated milk or food products.
1. Patient feels weak, nausea and loses appetite and alertness.
2. Once the mucus membrane surrounds the tonsils and nasal passage, the child has difficulty is swallowing food.
3. High fever.
4. Toxin spreads all over the body, excess of toxin may prove fatal.
5. Attack of heart and/or nervous system may cause parlysis.
(a) Faucial: Acute Tonsilitis.
(c) Laryngeal: Acute Laryngitis.
Faucal diphtheria is the commonest and severest type of diphtheria. It concerns throat infection.
Nasal diphtheria is the mildest type of diphtheria. It concerns nose infection.
Laryngeal diphtheria is not very common but it may occur along with faucial diphtheria, or even by itself. Its major liability is that it may cause laryngeal obstruction. It concerns vocal cords.
Initially 3-4 days without indicating symptoms, but once symptoms appear, it takes 2-5 weeks. The former is called incubation period, and the latter as infection period.
A Schick test is performed to see if a person is already immune to diphtheria. As the children are not immune to diphtheria preliminary Schick test is not performed. Three injections of diphtheria toxoid are given at the interval of one month each and the antibodies developed produce a lasting immunity to diphtheria.
This vaccine is introduced at the age of 6 weeks to 9 months, with a booster dose at the age of 2 years. It helps a child cross the age of infection-prone period.
Prevention and Control
1. The patient should be isolated in the home or in hospital.
2. The secretion of the nose and mouth are tested and culture test is performed. If diphtheria bacillus is noticed, the treatment of diphtheria is introduced.
3. Disinfections of the home, bedding, clothes, toys, utensils, etc., are done thoroughly. Boiling for 20-30 minutes or using some disinfectant like formalin, antiseptic lotions, etc.
4. Regular gargling should be recommended but the cough and secretion should be collected and burned.