What is DIPHTHERIA???

Have you ever wondered why you received a vaccine for Diphtheria, more likely as a child, or even what Diphtheria is?

Now, in regards to vaccines, whether it was for yourself, or your child, you have probably heard of Diphtheria, but in the form of its abbreviations of DTaP, Tdap, DT, and TD. The “D”, and the “T”, and the “P” are short for Diphtheria, Pertussis (also known as Whooping cough), and Tetanus. These are a combination of vaccines against these particular infectious diseases.

So who should receive Diphtheria vaccines: Those younger than 7 years old receive DTaP or DT, and those older than 7 (including adults) should receive Tdap and TD. According to the CDC, Adults should receive the Tdap or TD vaccine every 10 years.

Why?

Diphtheria rarely occurs in the United States and Western Europe, where children have been vaccinated, so why even care about it. Well, the reason it rarely occurs…IS BECAUSE we ARE vaccinated against it. But where vaccinations rates are low, such as in developing countries, Diphtheria is still quite alive and common. With our current ability to travel the world, why not prevent such an illness, and minimize our exposure risk.

So what is this Diphtheria?

It's name is from the Greek, diphthera, which means “leather hide”. Diphtheria is a serious infection caused by a bacteria named, Corynebacterium diphtheriae. This bacteria produces a poisonous toxin that causes extreme illness and even death. Diphtheria was discovered in 1884 by 2 German bacteriologists Edwin Klebs (1834–1912) and Friedrich Löffler (1852–1915).

If you did not know what Diphtheria was or is, and how deadly it still is…before the vaccine existed, Diphtheria was a leading cause of death in children in the United States and also around the world. Historically, before the vaccine was developed in the early 1920’s, and then became a mainstream vaccine in the 1940’s.

At the time, Diphtheria was one of the most feared infectious diseases. It was once called, the “strangling angel of children,” and can actually be traced as far back as the fourth or fifth century BC., where it was described by Hippocrates (The father of modern medicine.). The reason it was called this was because it was one of the most common causes of death among children.

Diphtheria epidemics in the United States and Europe resulted in fatality rates as high as 40%. That would mean that if 10 children contracted Diphtheria, 4 of them would die. As I mentioned, nowadays, Diphtheria rarely occurs in the United States, why…because of our immunization program.

In the rest of the world, Diphtheria does continue to cause illness, and death. Diphtheria damages the body from the toxin that is created by this Corynebacterium diphtheriae bacteria.

And don’t think that we are safe in the U.S., cause if we decide to forego the Diphtheria vaccine, there would be outbreaks as there was in as recent as 2018. The World Health Organization estimated that there were more than 16,000 new cases of Diphtheria around the world. So, if you think this virus is dead and gone, think again.

How is Diphtheria spread?

Diphtheria is spread from person to person from coughing or sneezing, which creates droplets, which then enter a person via the respiratory tract. Diphtheria can also be transmitted through contact such as touching of any open sores on skin.

Diphtheria bacteria can result in either Respiratory Diphtheria and or a Diphtheria Skin Infection.

In Respiratory Diphtheria signs & symptoms can include cough, Mild fever, Weakness, Sore throat, Swollen glands in the neck resulting in “Bull neck”. The bacteria enter a person’s lungs and attach to the lining of the respiratory system, creating poisons, and killing healthy tissues in the respiratory system.

This can then create dead tissue, forming a saran wrap like covering on tissues, in the nose and throat (mucous membranes) resulting in difficulty breathing, and can lead to suffocation. This saran wrap covering is technically called a grey pseudomembrane.

Respiratory diphtheria has a high mortality rate, even after treatment about 1 in 10 patients with respiratory diphtheria will die. And for those without treatment, up to about 50% of patients can die from the disease. Diphtheria skin infections do not usually cause any other severe disease, besides their own skin infections. Diagnosis occurs by obtaining a sample from an open sore and growing the bacteria, to see if it produces the poisonous toxin.

How do you Treat Diphtheria?

Diphtheria is treated 2 ways. First, to treat the respiratory diphtheria infections the bacterial toxin must be inactivated, by an anti-toxin, to prevent the “saran-wrap” like covering from covering the mucous membranes. If it is highly suspicious that the patient has Respiratory Diphtheria, treatment should not be delayed, until a definitive diagnosis is made.

Secondly, the bacteria must be treated using antibiotic therapy to actually kill the bacteria.

How do you prevent Diphtheria?

The main prevention of Diphtheria is through vaccination, via an intramuscular injection. If a person suspects that they have been exposed to someone with Diphtheria, then they should consider speaking to a medical provider for treatment.

Nursing Care: If you were to encounter a patient with Diphtheria, how would you care for them?

From a nursing perspective, nurses are going to assess and monitor the patients temp, oxygen saturation, and respiratory status.

Nursing intervention: administer antipyretics, oxygen, and antibiotics as ordered, encourage fluids and nutrition to promote healing.