Diphtheria is a very contagious and potentially life-threatening bacterial disease. Because of widespread immunization, diphtheria is very rare in the United States. It mainly affects the nose and throat. Diphtheria can also infect your skin. Children under 5 and adults over 60 years old are particularly at risk for contracting the infection. In 1993 and 1994, more than 50,000 cases were reported during a serious outbreak of diphtheria in countries of the former Soviet Union.



Causes

The best known and most widely studied species is Corynebacterium diphtheriae, the causal agent of the disease diphtheria. Usually the bacteria multiply on or near the surface of the mucous membranes of the throat, where they cause inflammation. Some types of C. diphtheriae release a toxin, a poison, which can damage the heart, the brain and the nerves.

It can also spread via the bloodstream to other organs, where it can cause significant damage. Although the toxin can damage any tissue, the heart and nervous system are most frequently and most severely affected.

Localized infection in the throat and tonsillar area produces a characteristic membrane that is gray to black, tough, and fibrous. This membrane can cause airway obstruction.

Symptoms

The onset of disease is usually gradual. Symptoms include fatigue, fever, a mild sore throat and problems swallowing. Children infected have symptoms that include nausea, vomiting, chills, and a high fever, although some do not show symptoms until the infection has progressed further. The infection also causes the lymph glands and tissue on both sides of the neck to swell to an unusually large size.Some people can be infected but not appear ill. They can also spread the infection.

For clinical purposes, it is convenient to classify diphtheria into a number of manifestations, depending on the site of disease.

1. Anterior nasal diphtheria

2. Pharyngeal and tonsillar diphtheria

3. Laryngeal diphtheria

4. Cutaneaous diphtheria

5. Other sites

Teatment

Treatment of diphtheria is in hospital with diphtheria anti-toxin to neutralise the diphtheria toxins in the body and with antibiotics to kill remaining bacteria.

Doctors may remove some of the thick, gray covering in the throat if the covering is obstructing breathing.

There may be other complications of diphtheria that need treatment. Inflammation of the heart (myocarditis) is treated with medications. In advanced cases, a person with diphtheria may need the assistance of a machine that helps them breathe (ventilator) until the infection is successfully treated.

Anyone who has had close contact with an infected person such as household members, visitors and anyone they have kissed or had sex with, should visit their GP immediately to be checked for signs of diphtheria.