Diphtheria: symptoms, causes, drugs, and ways to prevent

x

Definition

What is diphtheria?

Diphtheria is a disease caused by a bacterial infection Corynebacterium diphtheria , attacks the throat and upper respiratory system.

Not only that, these bacteria also produce toxins that can affect other organs.

As a result, this disease causes dead tissue to build up in the throat and tonsils, making it difficult to breathe and swallow.

Then, there is a possibility that the heart and nervous system can also be affected by this condition.

The disease is spread through direct physical contact from the breath, coughing or sneezing of an infected person.

Quoted from the CDC, this disease is the leading cause of child death worldwide before vaccines. However, in 2018 diphtheria was still a problem globally.

How common is this disease?

Diphtheria is common in developing countries with low vaccination rates.

This condition can occur in patients of any age including children and adults.

In general, 5 to 10 percent of people infected with diphtheria end up dying if their condition is susceptible.

A mortality rate of as much as 20 percent can occur in infected people under 5 years of age or over 60 years.

Symptoms

What are the signs and symptoms of diphtheria?

In its early stages, diphtheria is often mistaken for severe strep throat.

Other symptoms that appear include low-grade fever and swelling of the glands located in the neck.

This disease can also make sores on the skin so painful, red, and swollen.

It should be noted that diphtheria symptoms usually appear two to four days after infection and last for six days.

Although diphtheria bacteria can invade any tissue, the most prominent signs are throat and mouth problems.

Here are some of the common symptoms of diphtheria that can occur in children:

• The throat is covered with a thick gray membrane
• Sore throat and hoarseness
• Swollen glands in the neck
• Breathing problems and difficulty swallowing
• Sight becomes less
• Fever and chills
• Shock, such as pale skin, sweating, and a racing heart

The bacteria from this disease can be transmitted for up to four weeks if not treated with antibiotics. This can happen even if they have no symptoms.

There may be signs and symptoms not listed above.

If you have concerns about a certain symptom in children, consult a doctor immediately.

When should I see a doctor?

Immediately go to the hospital if you or your child has been in contact with someone who has diphtheria.

You also need to contact your doctor immediately if:

• Are in a widely infected area
• Just returned from a widely infected area
• Engage in close interaction with infected people

This disease requires immediate help to prevent complications, such as difficulty breathing and heart and kidney problems.

Cause

What causes diphtheria?

The cause of diphtheria is bacteria Corynebacterium diphtheriae which can produce toxins in the body .

These bacteria can spread disease through contaminated saliva, air, personal objects and household appliances.

The following is a complete review of the bacteria that causes diphtheria to spread or be contagious.

Air particles

If your child inhales airborne particles from coughs or sneezes of an infected person, chances are that he or she could have diphtheria.

This method is very effective for spreading disease, especially in crowded places.

Contaminated personal items

Another cause is contact with contaminated personal items.

You can get diphtheria by handling tissue from an infected person, drinking from an unwashed glass, or similar contact with objects that carry bacteria.

In rare cases, diphtheria is spread on household items that are shared, such as towels or toys.

The wound is infected

Touching an infected wound can also expose you to the bacteria that causes diphtheria.

What puts me at risk for this disease?

There are many risk factors that increase your or your child's chances of developing diphtheria, such as:

• Not doing or getting the latest vaccines
• Having an immune system disorder, such as AIDS
• Living in unsanitary or crowded conditions.

This condition occurs in many developing countries where awareness for immunization is still low.

This disease is a threat to children who are not vaccinated or traveling to countries where diphtheria is common.

Complications

What complications may occur due to diphtheria?

If left untreated, diphtheria can cause compilation in children:

Breathing problems

The bacteria that cause this disease may create toxins or poisons.

This toxin destroys the tissue in the infected area, usually the nose and throat.

In this condition, the infection produces a hard, gray membrane that is made up of dead cells, bacteria, and other substances. This membrane can inhibit breathing.

Heart damage

Diphtheria toxin may spread through the bloodstream and destroy other tissues in the body such as the heart muscle.

If you have this, the child can also experience complications of inflammation of the heart muscle (myocarditis).

Heart damage usually appears 10-14 days after infection. The heart damage associated with diphtheria is:

• Changes seen on an electrocardiograph (EKG) monitor.
• Atrioventricular dissociation, in which the chambers of the heart stop beating at the same time.
• Complete heart block, in which no electrical pulses pass through the heart.
• Ventricular arrhythmias, which are abnormal beats in the lower chambers of the heart.

Nerve damage

The bacterial toxins that cause diphtheria can also cause nerve damage. Usually, nerve damage occurs in the throat, making it difficult for children to swallow.

The nerves in the arms and legs can also become inflamed and cause muscle weakness.

If it's bacteria Corynebacterium diphtheriae damaging the nerves that regulate the respiratory muscles, they are paralyzed.

Usually, the disease will develop as follows:

• In the third week, there will be paralysis of the palate (pharynx).
• After the fifth week, there is paralysis of the eye muscles, limbs and diaphragm.
• Pneumonia and respiratory failure can occur due to paralysis of the diaphragm.

With proper treatment, most people with diphtheria are able to survive the complications above.

However, recovery was slow. Diphtheria is fatal in 3 percent of those who suffer from this disease.

Other illnesses due to infection in other locations

If a bacterial infection attacks tissue such as the skin, the pain is usually less severe. This is because the skin absorbs a smaller amount of toxins.

However, the cause of diphtheria on the skin can produce boils like yellow spots, appear clear and sometimes grayish.

Other mucous membranes can be infected by diphtheria, such as the conjunctiva of the eye, female genital tissue, and outer ear canal.

Diagnosis

How is diphtheria diagnosed?

The doctor will perform a physical examination to see the signs and symptoms before making a diagnosis to you or your child.

If the doctor sees a gray coating on the throat and tonsils, the doctor can suspect diphtheria.

The doctor can also ask about the child's medical history and symptoms.

However, the safest method for diagnosing diphtheria is to do a test swab .

A sample of the affected tissue will be taken and then sent to a laboratory for examination, and tested for toxicity:

• Clinical specimens taken from the nose and throat.
• All suspected cases and who came into contact with them were tested.

Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How to treat diphtheria?

The doctor will immediately treat diphtheria in children because it is a very serious condition.

The following steps may be taken by medical personnel:

Antitoxin

First, the doctor will give you an injection in the form of antitoxin diphtheria (DAT) to fight toxins produced by bacteria.

This diphtheria drug functions to neutralize toxins circulating in the body and prevent the development of diphtheria.

However, DAT cannot neutralize toxins that have already damaged cells in the body.

Diphtheria treatment through DAT can be given as soon as possible after a clinical diagnosis, without waiting for confirmation of the laboratory diagnosis.

If your child has an allergy to antitoxin, you need to tell the doctor so that he can adjust the treatment.

Diphtheria treatment through DAT is not recommended in cases of cutaneous or diphtheria cutaneous diphtheria who show no symptoms.

Side effects of antitoxins that parents need to be aware of:

• Fever
• Allergies such as itching, redness, or hives
• Shock such as shortness of breath and drop in blood pressure (rare)
• Joint pain and body aches

Antibiotics

After that, the doctor will give antibiotics, such as erythromycin and penicillin , to help fight infections.

Administration of antibiotics in the treatment of diphtheria in children or adults is not a substitute for DAT.

Although antibiotics have not been shown to affect the cure of diphtheria infection, drugs are still given.

This is done to eradicate bacteria from the nasopharynx so as to prevent further transmission of diphtheria to other people.

Advanced care

Don't worry if the doctor asks the child to stay in the hospital. This is to monitor the reaction to treatment and prevent the spread of disease.

Isolation will be carried out on Intensive Care Unit (ICU) because this disease spreads easily and quickly.

Usually, the patient will be hospitalized for 14 days of giving the antibiotic diphtheria drug

The treatment and care steps will be carried out continuously until the examination results turn negative.

What are the home remedies for this disease?

Here are home remedies that parents can do to treat diphtheria in children:

• Make sure the child gets plenty of bed rest and limit tiring physical activity.
• Tight isolation. You should avoid spreading the disease to other people if your child is infected.

If the child is cared for at home, wear a mask to prevent transmission. Don't forget to keep things clean and wash your hands all the time.

When recovering from this disease, children and parents may need a complete diphtheria vaccine to prevent recurrence.

Having experienced this condition does not guarantee that you will be immune for life.

Children or adults can experience this disease more than once if they do not complete immunization.

Prevention

How to prevent diphtheria?

The following are prevention efforts that parents can take for this disease:

Doing a vaccine

Before antibiotics were created, diphtheria was a common disease in children. But now, the disease is not only treatable, but also preventable with vaccines.

According to WHO, vaccination has dramatically reduced mortality and morbidity from diphtheria.

However, the disease remains a major child health problem in countries with low Environmental Performance Index (EPI) scores.

This vaccine is a bacterial toxoid, that is, a toxin whose toxicity has been deactivated.

Usually given in combination with other vaccines, such as for tetanus and pertussis.

Therefore, as a prevention for diphtheria children need DPT vaccines (diphtheria, tetanus, and pertussis).

Meanwhile, for adults, the vaccine given is usually mixed with tetanus toxoid with a lower concentration.

Immunization for diphtheria prevention is usually done in stages, namely at the age of 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years.

There are several side effects of this vaccination. Children may experience low-grade fever, fussiness, drowsiness, and numbness at the injection site.

Ask your doctor about how to reduce or eliminate these effects.

In rare cases, the DPT vaccine can cause serious complications in children.

For example, allergic reactions (itching or a rash that develops a few minutes after the injection), seizures, or shock. However, this condition is treatable.

Some children, especially those with epilepsy or other nervous system conditions, may not be recommended the DPT vaccination.

Additional injection

After a series of immunizations during childhood, under certain conditions a diphtheria vaccine booster injection is needed to maintain immunity.

This is because the body's immunity to the disease disappears over time.

Children who have passed vaccine recommendations before age 7 should have their booster shot by age 18.

The booster injection in the form of the Tdap vaccine is recommended to be carried out in the next 10 years, and to be repeated every 10 years.

Tdap is a combination of tetanus, diphtheria, and acellular pertussis (whooping cough) vaccines.

This is a one-time alternative vaccine for adolescents ages 11 to 18 and adults who have not previously received booster shots.