Diphtheria (dif-THEER-e-uh) is a serious bacterial infection usually affecting the mucous membranes of your nose and throat. Diphtheria typically causes a sore throat, fever, swollen glands and weakness. But the hallmark sign is a sheet of thick, gray material covering the back of your throat. This material can block your windpipe so that you have to struggle for breath.
Today, diphtheria is extremely rare in the United States and other developed countries thanks to widespread vaccination against the disease.
Medications are available to treat diphtheria. However, in advanced stages, diphtheria can cause damage to your heart, kidneys and nervous system. Even with treatment, diphtheria can be deadly — as many as 10 percent of people who get diphtheria die of it.
One sign of diphtheria is swollen glands (enlarged lymph nodes) in the neck. ...
Signs and symptoms of diphtheria may include:
Signs and symptoms usually begin two to five days after a person becomes infected.
In some people, infection with diphtheria-causing bacteria causes only a mild case of the illness — or no obvious signs and symptoms at all. Infected people who remain unaware of their illness are known as carriers of diphtheria, because they can spread the infection without being sick themselves.
Skin (cutaneous) diphtheria
Although it's more common in tropical climates, cutaneous diphtheria also occurs in the United States, particularly among people with poor hygiene who live in crowded conditions.
In rare instances, diphtheria affects the eye.
When to see a doctor
The bacterium Corynebacterium diphtheriae causes diphtheria. Usually C. diphtheriae multiply on or near the surface of the mucous membranes of the throat. C. diphtheriae spreads via three routes:
You can also come in contact with diphtheria-causing bacteria by touching an infected wound.
People who have been infected by the diphtheria bacteria and who haven't been treated can infect nonimmunized people for up to six weeks — even if they don't show any symptoms.
People who are at increased risk of contracting diphtheria include:
Diphtheria rarely occurs in the United States and Europe, where health officials have been immunizing children against the condition for decades. However, diphtheria is still common in developing countries where immunization rates are low.
In areas where diphtheria is a standard vaccination, the disease is mainly a threat to unvaccinated or inadequately vaccinated people who travel internationally or have contact with people from less-developed countries.
Left untreated, diphtheria can lead to:
With treatment, most people with diphtheria survive these complications, but recovery is often slow. Diphtheria is fatal in as many as one in 10 cases.
Preparing for your appointment
If you have symptoms of diphtheria or have come into contact with someone who has diphtheria, call your doctor right away. Depending on the severity of your symptoms and on your vaccination history, you may be told to go to the emergency room or call 911 for emergency medical help.
If your doctor determines that he or she should see you first, it's critical to be well prepared for your appointment. Here's some information to help you get ready, and what to expect from your doctor.
Information to gather in advance
The list below suggests questions to raise with your doctor about diphtheria. Don't hesitate to ask more questions during your appointment at any time that you don't understand something.
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Tests and diagnosis
Doctors may suspect diphtheria in a sick child who has a sore throat with a gray membrane covering the tonsils and throat. Growth of C. diphtheriae in a laboratory culture of material from the throat membrane pins down the diagnosis. Your doctor should notify the laboratory that diphtheria is suspected because special media are needed for the growth of C. diphtheriae cultures.
Doctors can also take a sample of tissue from an infected wound and have it tested in a laboratory, to check for the type of diphtheria that affects the skin (cutaneous diphtheria).
If a doctor suspects diphtheria, treatment begins immediately, even before the results of bacterial tests are available.
Treatments and drugs
Diphtheria is a serious illness. Doctors treat it immediately and aggressively with these medications:
Children and adults who have diphtheria often need to be in the hospital for treatment. They may be isolated in an intensive care unit because diphtheria can spread easily to anyone not immunized against the disease.
Doctors may remove some of the thick, gray covering in the throat if the covering is obstructing breathing.
Doctors treat people who are found to be carriers of diphtheria with antibiotics to clear their systems of the bacteria, as well.
Before antibiotics were available, diphtheria was a common illness in young children. Today, the disease is not only treatable but is also preventable with a vaccine.
The diphtheria vaccine is usually combined with vaccines for tetanus and whooping cough (pertussis). The three-in-one vaccine is known as the diphtheria, tetanus and pertussis vaccine. The latest version of this vaccine is known as the DTaP vaccine for children and the Tdap vaccine for adolescents and adults.
The diphtheria, tetanus and pertussis vaccine is one of the childhood immunizations that doctors in the United States recommend during infancy. Vaccination consists of a series of five shots, typically administered in the arm or thigh, given to children at these ages:
The diphtheria vaccine is effective at preventing diphtheria. But there may be some side effects. Some children may experience a mild fever, fussiness, drowsiness or tenderness at the injection site after a DTaP shot. Ask your doctor what you can do for your child to minimize or relieve these effects.
Rarely, the DTaP vaccine causes serious complications in a child, such as an allergic reaction (hives or a rash develops within minutes of the injection), seizures or shock — complications which are treatable.
Some children — such as those with progressive brain disorders — may not be candidates for the DTaP vaccine.
You can't get diphtheria from the vaccine.
Children need their first booster shot at around age 12. The next booster shot is recommended 10 years later, then repeated at 10-year intervals. Booster shots are particularly important if you travel to an area where diphtheria is common.
The diphtheria booster is combined with the tetanus booster in one vaccine — the tetanus-diphtheria (Td) vaccine. This combination vaccine is given by injection, usually into the arm or thigh.
Doctors recommend that anyone older than age 7 who has never been vaccinated against diphtheria receive three doses of the Td vaccine.
The Centers for Disease Control and Prevention also recommend a one-time combined tetanus toxoid, reduced diphtheria and acellular pertussis (Tdap) vaccine for adolescents around the age of 12 and for anyone older than that who hasn't received the vaccine in the past — or doesn't know if they've received the vaccine. It's also recommended for anyone who's pregnant, regardless of previous vaccination status.
Lifestyle and home remedies
Recovering from diphtheria requires lots of bed rest. Avoiding any physical exertion is particularly important if your heart has been affected. You may need to stay in bed for a few weeks or until you make a full recovery.
Strict isolation while you're contagious also is important to prevent spread of the infection. Careful hand-washing by everyone in your house helps prevent spread of the infection. Because of pain and difficulty swallowing, you may need to get your nutrition through liquids and soft foods for a while.
Once you recover from diphtheria, you'll need a full course of diphtheria vaccine to prevent a recurrence. Having diphtheria doesn't guarantee you lifetime immunity. You can get diphtheria more than once if you're not fully immunized against it.
Last Updated: 2013-03-19
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