Diphtheria is a serious bacterial infection caused by the microorganism Corynebacterium diphtheriae, affecting especially the mucous membranes of the throat and nose, and most commonly seen in children. You can find answers to your questions such as what diphtheria means, what are the symptoms of diphtheria, and how does diphtheria go in the rest of the article.
What is diphtheria?
The infection, first described by Pierre Bretonneau in 1826, is the reason why membrane formation is observed in the course of the disease. It was named "Diphtherie", which means "leather/covering" in Greek. The microorganism that caused diphtheria was first grown in cultures by Loeffler in 1884, and in a few years antitoxin was developed to be used in treatment in response to the toxin produced by the microorganism.
16. From the 19th century to the 20th century, epidemics were experienced due to diphtheria in many European countries and the United States, and thousands of people died as a result of the cases. By the 1980s, diphtheria, which decreased its effectiveness, reached the lowest number of cases of all time and was seen in only 683 people in Europe. Between 1982-1985 and 1990-1995, there were 2 epidemics in the former Soviet Republics. More than 150,000 people have been affected by the epidemic.
Diphtheria is a rare but easily transmitted disease. The fact that the possibility of diphtheria is not thought of by the physicians during the examination delays the treatment of the disease and causes it to spread. In our country, an effective fight against diphtheria was achieved by increasing the vaccination rates within the framework of the "Turkey Vaccination Campaign" initiated in 1985. Vaccines made since childhood have given their results and diphtheria has not been seen in Turkey since 2002, except for one diphtheria case in 2011.
What Causes Diphtheria?
Diphtheria disease (bird abalone), corynebacterium diphtheriae It is caused by a toxin produced by the bacterium. The toxin it produces is a protein that can easily enter the cell. A single molecule of this toxin can cause cell death by stopping protein synthesis within a few hours. Doses as small as 0.1 µg/kg can kill an organism if it is sensitive. Bacteria are most common in the nose and throat. infects. Bacteria that settle in the throat and nasal mucosa spreads to the blood circulation with the toxin they secrete. It creates a gray membrane-like structure in the throat and nose. It causes a decrease in the number of platelets that allow blood to clot. An abnormal increase in the amount of protein excreted in the urine is observed. Diphtheria, which can be transmitted by contact and air, can also cause necrosis by affecting tissues and nerves in advanced cases. It can lead to life-threatening complications such as myocarditis, stroke, kidney failure.
What are the Symptoms of diphtheria?
The most visible and common symptoms of diphtheria are:
- Gray in the throat and tonsils image of white membranes
- Fever
- Chilly
- Swollen glands in the neck
- Cough
- Salivation
- Sneezing
- Congestion
- Runny nose
- Sore throat
- Swollen glands
- Headache
- Body aches
- Loss of appetite
- A general feeling of restlessness and discomfort
Additional symptoms may occur as the infection progresses:
- Difficulty breathing and swallowing
- Nausea
- Vomiting
- Vision problems
- Speech impairment
- Pale and cold skin,
- Excessive sweating
- Rapid heartbeat
- Shock symptoms
- Soft palate paralysis
- Acute heart failure
How is diphtheria transmitted?
Diphtheria, which is known as "bird palsy disease" among the people, can easily be transmitted from person to person through respiratory or direct contact with skin lesions. As a result of the sneezing or coughing of the infected person, diphtheria can be transmitted to a healthy individual through the path called droplet infection. Bacteria are also spread by direct contact with personal items such as cups, pens, handkerchiefs used by the sick individual. Even if the patient's complaints disappear, the risk of contamination continues until 6 weeks after the bacteria is taken into the body. For this reason, close or direct contact should be avoided within the specified period of time, even if full recovery is observed in order to prevent transmission.
How Is Diphtheria Treatment Applied?
The primary goal in diphtheria treatment is to prevent the spread of bacteria. Antibiotic treatment is applied to remove the bacteria from the area and lose its effectiveness. Treatment with antibiotics such as erythromycin or penicillin usually takes 2-3 weeks. In severe cases, antitoxin injection can be applied. Diphtheria antitoxin is a serum produced from horses. Antitoxin captures and neutralizes free-flowing toxins. The dose and duration of the antitoxin to be administered vary depending on the course and duration of the disease, the location and size of the membrane. In diphtheria, which can be rapidly transmitted through the respiratory tract, the person or people who come into contact with the infected person may also need to take antibiotics. In the treatment of diphtheria on the skin, in addition to the diphtheria treatment, the wounds should be cleaned thoroughly to reduce the risk of infection. It is very important for people who do wound cleaning to avoid direct contact. During the treatment, your doctor may ask you to stay in the hospital so that you do not transmit the infection to others.
How Is Diphtheria Diagnosed?
The characteristic membrane image in the physical examination performed in line with the patient's complaints is sufficient for the diagnosis of diphtheria. In suspected cases where the membrane structure is not seen, treatment is started immediately. For definitive diagnosis, swab samples taken from sores or skin wounds are cultured. The diagnosis of the disease is made with the test results from the laboratory.
What is diphtheria vaccine?
To protect against a disease is to treat. It is always more important than doing. In line with this principle, the most important tool of preventive medicine is vaccination. Diphtheria is one of the diseases that can be prevented by vaccination. In our country, diphtheria vaccine was administered in 1937 with a single dose and extremely effective results were obtained. The World Health Organization started the Expanded Program on Immunization for the first time in 1974 to apply vaccines against diphtheria, pertussis, tetanus, measles and tuberculosis. In our country, mixed vaccine (diphtheria-pertussis-tetanus vaccine) was administered in the 1970s. Since 2008, diphtheria vaccine is administered as a 5-in-1 mixed vaccine (DaBT-IPA-Hib) at 2,4, 6, and 18 months in the newborn vaccination calendar. The protective efficacy of diphtheria vaccine was determined as 97% in clinical findings. Diphtheria-tetanus vaccines, which last for about 10 years, should be repeated every 10 years or when traveling to risky geographies. There is no obstacle to vaccination in pregnant women. The diphtheria vaccine, which is safe and highly effective against the disease, may rarely have side effects. Regional reactions are the most common side effects. Sensitivity, skin rash, hardening of the skin and redness may occur at the injection site. Although it is not common, it has been observed in some people with fever. The side effects that occur after vaccination improve without any treatment. It should not be forgotten that if there are symptoms that occur during travel to these countries or in contact with suspicious people, a doctor should be consulted without neglecting it.
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