It is a highly infectious caused by the Bacterium ‘Coryne-bacterium diphtheriae’ which generally affects the throat at the initial stage but may also infect other mucus membranes and the skin. It is spread by direct contact with an infected patient, carrier or contaminated food. Sometimes, it spreads so fast that it assumes an epidemic form.
After an initial lying-in-period of 2-6 days, the patient has fever, chill, sore throat, swollen tonsils and very foul breath. Due to formation of false membrane on the throat, the patient has difficulty in breathing and swallowing and, if not contained immediately, the patient may die due to suffocation. When the infection spreads to blood-stream, in the form of release of a toxin, it may damage heart and Nerves when death may occur, within 4 days, due to heart failure or collapse. The initial and subsequent complications can be controlled by administration of penicillin and antitoxins which arc capable of controlling the disease but, for complete recovery absolute bed-rest, for a long period, is necessary.
In developed countries, Diptheria is, now, a rare occurrence due to effective immunisation on large scale, though developing countries have also launched immunisation programmes. In certain countries, infants are effectively immunished by giving antitoxin vaccine.
Caution
Those who have frequent complaints of sore-throat tonsilltis, laryngitis and pharyngitis are more exposed to diphtheria, and so such persons should always guard against invasion of this bacteria. As soon as initial symptoms are noticed, the patient must be secluded from other healthy persons and then removed, without any delay, to a hospital where all the relevant clinical tests and examination would be undertaken and stage of the disease determined. Since the malady can prove fatal, which it often does, no chance should ever be taken as to prompt removal of the patient to infectious diseases hospital or, at least, nearby health centre but, in no case, domestic medicines be tried, much, to the detriment of the patient. If the patient is a child, urgency is all more necessary.
Not only the patient but all those at home or staying in the hospitals or health centres need to be treated with antitoxin treatment.
Clinical features of Diphtheria
Laryngeal infection, membranous tonsillitis, Nasal infection or infection emanating due to infections in wound, skin or conjunctiva are the other causes and seats of infection which can precipitate onset of this disease. More serious, complex situations/complications, like Peripheral Neuropathy, Laryngeal paralysis or obstruction, myocarditis, may also surface which are the resultant fall-out effects of diphtheria.
Allopathic Treatment and other related measures
– Isolate the patient at once
– Inform a nearby public health authority/centre/clinic/Hospital.
– Protect close contacts from the patient and contacts should be given Erythromycin or, if possible, all of them should be immunised.
– After testing, given 4000-32000 units by intramuscular route, of anti-toxin agent.
– Follow with a 60-hourly dose of Benzylpenicillin intravenously for a week.
– Take note of and also treat complications pertaining to respiratory obstruction, myocarditis (which causes arrhythmia).
– If trachea is needed to be resorted to, do not delay the operation, but all other factors be taken into active consideration before deciding about tracheostomy.
– Breathing should be maintained as soon and as far possible, even if surgical means are to be adopted.
It is repeated that delay in treatment can prove fatal for the patient. Hence, whenever any one of the leading symptoms is noticed, the doctor must be approached. The afroesaid line of treatment has been suggested to meet exigent situations only or when doctor is not available, or for any other cause whatsoever. As a preventive measure, the malady is not likely to surface if one has already been immunised by anti-diphtheria vaccination, but chances of emergence of the disease cannot and should not be ruled out as immediate causes often trigger onset of disease. Extra caution and care is all the more necessary in case of infants and ‘children.