In the United States, medical professionals have reported only five cases of diphtheria since 2000, but this bacterial infection still exists in developing nations. Even in these regions, instances of the condition are decreasing due to immunizations children routinely receive, but diphtheria remains a serious, potentially fatal illness in areas to which unvaccinated individuals travel. In people who contract the condition, there is a five to ten percent death rate, which rises for those under age 15. Complications of diphtheria can cause heart, kidney, and nervous system damage.
Causes: Lack of Immunization and Environment
At highest risk of diphtheria are adults and children who have not been immunized or are not up to date with their shots. Diphtheria most often develops in dense populations or unsanitary conditions. Anyone who travels to these areas should be fully immunized. Western Europe and the United States have had immunization programs for decades, and the illness is almost nonexistent.
Causes: The Spread of the Bacteria
One way to acquire the illness is by inhaling droplets in the air after someone sneezes or coughs. Diphtheria spreads quickly this way, especially in crowded environments. Some people who have the Corynebacterium diphtheriae bacteria that causes diphtheria in their respiratory system do not know it because they have no symptoms, but they can spread it to others if they cough or sneeze.
Causes: Contaminated Objects
Bacteria can inhabit items that are in contact with the infected person, such as used tissues, towels, toys, utensils, glasses, plates, and other household items. Also, the infection may spread if someone touches an open sore on an infected individual. People with diphtheria can spread the illness for up to six weeks, regardless of whether or not they are exhibiting symptoms.
Diphtheria Can Cause Heart Problems
Toxins, poisons created by the bacteria, can travel from the throat to other parts of the body through the bloodstream. The toxins can damage the heart muscle by weakening it and can create inflammation of the heart muscle or myocarditis. The damage may be mild or severe. Rarely, these complications can cause congestive heart failure or sudden death.
Diphtheria Can Cause Nerve Damage
A person with diphtheria may find swallowing difficult because the toxin can damage the nerves in the throat. Breathing may also become labored due to the toxin affecting the nerves and muscles involved in respiration. This can result in paralysis, and infected people may need a respirator or other breathing device. Diphtheria can also badly damage the kidneys and may even require dialysis.
Treatment of diphtheria must begin immediately to eradicate the bacteria from the bloodstream. Antitoxins are antibodies that also treat diseases such as botulism and tetanus. Animals, bacteria, and plants contribute to these medications, which render toxins harmless. Some people may be allergic to the antitoxin, but often the doctor can work around this issue by slowly increasing the dosage.
Antibiotics kill the bacteria, rid the body of the infection, and shorten the time a person is contagious. Often, the patient needs to be hospitalized and is put in isolation because the illness spreads so easily. People who have been exposed to diphtheria should visit their physician and get a preventive course of antibiotics if they test positive, as well as a diphtheria booster shot. A carrier is a person infected with the bacteria but without symptoms — these people can also receive antibiotics to eradicate the infection.
Treatment: Home Care
The best thing anyone with diphtheria can do at home is rest and avoid physical exertion. People from whom the infection causes heart damage may require weeks of recovery at home, during which time they should avoid interaction with others and take extreme precautions with hygiene. Additionally, all members of the household will require immunization.
Treatment: Post-Recovery Care
Unlike some infectious diseases, contracting diphtheria does not result in life-long immunity. After recovery, individuals should receive the full vaccine course to prevent a recurrence. Unfortunately, some patients may be left with long-lasting conditions such as arthritis, paralysis, or brain damage. Some may also need additional heart monitoring.
Treatments: Cutaneous Diphtheria
This appears on the skin as a lesion that grows and becomes ulcerated. Doctors may test for the bacteria using a culture. If cutaneous diphtheria is present, the individual will require antibiotics immediately, and may need isolation until two subsequent cultures are negative. This type of diphtheria is common in tropical areas of the world and is another reason full immunization of travelers is essential.