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Diphtheria


What is Diphtheria?
Diphtheria is a contagious bacterial disease of the upper respiratory system. It is mainly spread by the coughing and sneezing of infected persons. The first symptoms appear two to five days after infection. They include a sore throat, headache, coughing, fever, and swollen lymph nodes in the neck. As the disease progresses, a thick membrane forms on the surface of the tonsils and throat, and may extend into the windpipe and lungs. This membrane may interfere with breathing and swallowing. In severe cases, it can completely block the breathing passages and cause death if not treated. Other complications include inflammation of the heart muscle and respiratory paralysis.(1)

Diphtheria requires medical attention but is treatable with common antibiotics such as penicillin. Heart failure is treated with medication, while a respirator is used to aid in breathing. A diphtheria antitoxin may also be administered.(2)

Is diphtheria a common disease?
Diphtheria was a common disease during the late 19th century. For example, from 1891 to 1895, Massachusetts recorded an average of 2,700 cases per year. New York averaged 7,200 cases per year.(3,4) The case-fatality rate was about five percent.(5,6) In the United States during the 1940's, the number of diphtheria cases fluctuated between 15,000 and 30,000 annually.(7) However, in 1980 a new pattern emerged, with only a few cases occurring each year. In fact, from 1980 to 1989, there were just 24 cases in the entire country. Eighteen of these (75 percent) were in persons 20 years of age or older. Two of the cases were fatal.(8) From 1990 to 2000 (an 11-year period), 25 cases of diphtheria were recorded. Three of these cases were fatal [Figure 1].(9,10)

Does a diphtheria vaccine exist?
A diphtheria antitoxin became available in 1895 and was used on a limited scale from the beginning of the 20th century through the early 1940's. It supplied the body with a quick infusion of diphtheria-fighting antibodies. This antitoxin was administered to persons with low diphtheria antibody levels or immediately after being exposed to the disease.(11) Today, a diphtheria antitoxin is still available. It is derived from the blood of horses after they are inoculated with diphtheria organisms.(12)

A diphtheria vaccine was introduced in the 1920's. However, widespread use of this modified toxoid did not occur until the 1940's when it was combined with the tetanus and pertussis vaccines. This became known as DPT. Today, the diphtheria toxoid is administered in conjunction with the tetanus vaccine (DT), or in combination with both tetanus and acellular pertussis vaccines (DTaP).(13,14)


This article was excerpted from...
Vaccines: Are They Really Safe and Effective?
by Neil Z. Miller.
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