Diphtheria
Diphtheria; infection; child; immunisation; immunise; vaccination; vaccine ;
Contents
Diphtheria has been rarely seen in Australia since children and adults have been immunised against it (immunisation was started in the 1890s but it was not until the 1940s that immunisation became widespread in Australia). It was a serious disease which was sometimes the cause of death of several children in a family within a few days or weeks of each other in the 1800s and earlier. In the early 1900s diphtheria caused more deaths in Australia than any other infectious disease. There are still occasional cases of diphtheria in Australia where most children are immunised, but in countries where the immunisation programs are not working well (often due to war or extreme poverty) diphtheria has become a serious problem again.
What is diphtheria?
- Diphtheria is an infection caused by bacteria (Corynebacterium diphtheriae).
- It usually affects the throat, tonsils and nose.
- A white or grey-looking membrane (which initially looks like a spider web) forms on the back of the throat or in the nose.
- The membrane is stuck on and trying to remove it causes bleeding and does not help as the membrane just comes back.
- Some types of the bacteria also produce a toxin (poison) which can affect other parts of the body such as the brain and the heart.
- In Australia about 10% of children (or adults) who get diphtheria die from it.
How is diphtheria spread?
- The disease is usually spread from person to person by contact with droplets from the nose or throat (sneezed or coughed).
- It can also be spread by used tissues or handkerchiefs.
Who is at risk from diphtheria?
- Before immunisation was available, children under 15 years were most at risk.
- In the recent epidemic in the States of the former Soviet Union, people at greatest risk were those over 15 years. Most of those affected were not immunised.
- It is rare in Australia since vaccines have been used.
How long does it take to develop?
- The infection in the throat begins about 2 to 5 days after the person is exposed to the infection.
Signs and symptoms
- Symptoms of diphtheria include a fever, sore throat, swollen neck glands, swollen neck and a runny nose.
- Mostly it affects the throat, but sometimes the infection starts in the nose. The sore throat is mild at first, then becomes more severe with swelling of the lining of the mouth and throat, and a membrane forms. It starts off looking like a spider web, then gets thicker, sticking to the back of the throat or inside the nose. The child may be very unwell and find it hard to breathe.
- Diphtheria should be suspected when a membrane can be seen, and it is confirmed when the bacteria are seen under a microscope.
- The membrane and swelling of the tissues in the neck (making the neck look thicker, which is sometimes called a 'bull neck') may block the throat making it hard to breathe.
- The toxin can affect other parts of the body causing damage to the heart and paralysis of muscles (often muscles in the mouth and throat).
- Most doctors in developed countries such as Australia have not seen a case of diphtheria, which may lead to a delay in diagnosis if a case does occur.
Treating diphtheria
- Diphtheria can be treated with antibiotics (often penicillin) and with an antidote to the toxin, but this may not get rid of all of the problems quickly.
- In Australia diphtheria is fatal in about 10% of those who have it despite treatment.
Stopping the spread of diphtheria
- Making sure that the whole population is immunised is the only effective way of stopping the spread of diphtheria.
- Children receive 4 doses of vaccine before the age of 5 years, then one around the age of 15, (see the topic 'Immunisation' for more information).
- A person with diphtheria will need to be isolated until he or she is proven to be free of the disease (usually about 24 hours after starting treatment).
- People who have been in contact with an infected person need to be checked for the infection, given antibiotics if needed, and vaccinated.
- Family or household contacts will need to be excluded from school, preschool, childcare or work until they are cleared to return by the local health authority.
- People travelling to countries where diphtheria is common should be fully immunised before they travel (this may include having a booster even if a full course of immunisation has been given).
- Diphtheria is a notifiable disease in Australia (it must be reported to health authorities so that contacts can be traced and treated as needed).
References
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
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child's sex.