Diphtheria

Diphtheria is most common in low socioeconomic groups where people live in crowded conditions. Unimmunized children under 15 years of age are likely to contract diphtheria. The disease is often found among adults whose immunization was neglected and is most severe in unimmunized or inadequately immunized individuals.

Diphtheria is transmitted to others through close contact with discharge from an infected person's nose, throat, skin, eyes and lesions.

There are two types of diphtheria. One type involves the nose and throat, and the other involves the skin. Symptoms include sore throat, low-grade fever and enlarged lymph nodes located in the neck. Skin lesions may be painful, swollen and reddened.

Symptoms usually appear two to four days after infection, with a range of one to six days.

Untreated people who are infected with the diphtheria germ can be contagious for up to two weeks, but seldom more than four weeks. If treated with appropriate antibiotics, the contagious period can be limited to less than four days.

Recovery from diphtheria is not always followed by lasting immunity.

Diphtheria toxoid is usually combined with tetanus toxoid and pertussis vaccine to form a triple vaccine known as DTP. This vaccine should be given at two, four, six and 15 months of age, and between four and six years of age. A combination of tetanus toxoid and diphtheria toxoid (Td) should be given every 10 years to maintain immunity.

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Certain antibiotics, such as penicillin and erythromycin, can be prescribed for the treatment of diphtheria.

If diphtheria goes untreated, serious complications such as paralysis, heart failure and blood disorders may occur. Death occurs in approximately 5 to 10 percent of all cases.

The single most effective control measure is maintaining the highest possible level of immunization in the community. Other methods of control include prompt treatment of cases and a community surveillance program.