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https://studentshare.org/health-sciences-medicine/1425765-diphtheria.
Diphtheria Overview of the Disease: Diphtheria is a kind of infection which is instigated by a special type of bacterium called as Corynebacterium diphtheriae. The disease derives its name from the name of the bacterium causing it. Airborne respiratory droplets are the primary means of transmittal of diphtheria from one individual to another. Direct contact with the secretion of patient can also transmit diphtheria to others. Primary symptoms of the disease are fever, problematic breathing, sore throat, malaise and neck enlargement.
Antibiotics and antitoxins are used for treating the patient with diphtheria. If proper treatment is not given on time, diphtheria may cause neurologic and cardiac problems in the patient and cause death. Best way to prevent diphtheria is immunization. Etiology of Diphtheria: The chief cause of diphtheria is toxigenic strains of the Corynebacterium diphtheriae. In few cases, Corynebacterium ulcerans may also instigate the disease in an individual. “C diphtheriae is an irregularly staining, gram-positive, nonspore-forming, nonmotile, pleomorphic bacillus with 4 biotypes (mitis, intermedius, belfanti, and gravis)” (AAP, 2009).
Biotypes of the C diphtheriae can be nontoxigenic or toxigenic in nature. The Victims of Diphtheria: Children are primarily the victims of diphtheria. A lot of children have lost their lives due to diphtheria in the past. 100,000 to 200,000 Americans acquired diphtheria every year in the 1920s and 13,000 to 15,000 lost their lives every year. From 1735 to 1740, when diphtheria spread in the New England Colonies, 80 per cent of the children who were below 10 years of age died (Ries, 2011). Symptoms and Prognosis of Diphtheria: After two to five days of incubation, symptoms of diphtheria start to show up.
Symptoms include but are not limited to 1. Fever 2. Hoarseness 3. Sore throat 4. Troubled breathing, and 5. Malaise As diphtheria progresses in the patient, a gray membrane known as pseudomembrane starts to form upon the tissues that line the nasopharynx or tonsils or both. In severe cases, the patient’s neck swells and lymph nodes enlarge, thus making it bull-neck. If the pseudomembrane extends up to trachea and larynx, it may obstruct the passage of air and the patient may die of suffocation.
Diphtheria toxin, of disseminated, may instigate the systemic disease that may cause the heart to inflame; a condition known as myocarditis. Several neurologic problems may also arise including weakness of muscles, vision problems, and soft palate. Cutaneous diphtheria is a special type of diphtheria in which the patient develops a non-healing ulcer in the skin which is covered by a membrane. This form of diphtheria is often not linked with systemic complications and is only a localized infection.
Treatment of Diphtheria: Suspicion of diphtheria in an individual is sufficient to instigate prompt treatment even before the lab results could confirm the disease (MedicineNet.com, 2011). The foundation of therapy is diphtheria antitoxin. Its effectiveness is maximum when administered in the initial stages of the disease. However, antitoxin is not of much value in the case of localized cutaneous diphtheria and can not be chosen as a treatment of asymptomatic carriers. The patient of diphtheria should be administered with antibiotics as they eradicate bacteria from the body, thus bringing the toxin production to a halt.
Besides, antitoxins also prevent the transmission of disease to other people. Two of the most recommended antibiotics for the treatment of diphtheria are erythromycin and penicillin. Antibiotic treatment should also be given to people in close contact with the patient in addition to the patient himself. In case when the neck is swollen to the extent as to cause problem in breathing, insertion of breathing tube i.e. intubation is the right choice for treatment. The patient should consult a specialist for potential neurologic and cardiac complications.
Prevention of diphtheria: In order to prevent diphtheria, immunization with vaccines containing diphtheria toxoid is being increasingly used. “The diphtheria/pertussis/tetanus (DTP) vaccination is given soon after birth, with several booster shots administered in early childhood” (Ellis-Christensen, 2011). Infants may be given five DTaP vaccinations, three of which have to be given after every two months starting from the second month up to the sixth month of the first year, the fourth vaccination should be given between the fifteenth and eighteenth month, whereas the fifth vaccination should be given anywhere between four to six years of age.
Upon completion of the recommended schedule of childhood vaccination, children should be given a single Tdap vaccination at the age of eleven or twelve years. Because of the tendency of immunity to wane with the passage of time, booster immunization should be subsequently given at the intervals of ten years in order to maintain good levels of protective antibodies in the body. References: American Academy of Pediatrics. (2009). Diphtheria. Red Book Online. Retrieved from http://aapredbook.aappublications.
org/cgi/content/full/2009/1/3.36. Ellis-Christensen, T. (2011). What is Diphtheria? Retrieved from http://www.wisegeek.com/what-is-diphtheria.htm. MedicineNet.com (2011). Diphtheria. Retrieved from http://www.medicinenet.com/diphtheria/page3.htm#treatment. Ries, V. (2011). History of Diphtheria. Retrieved from http://www.ehow.com/about_4617439_history-of-diphtheria.html.
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