Corynebacterium diphtheria diphtheria is an acute and highly contagious bacterial disease that usually attacks the upper respiratory system or the skin. It affects children under five, adults over sixty, those living in crowded or unsanitary conditions, the undernourished, and children and adults who do not have up-to-date immunizations. The genus is named from the Greek koryne, meaning club because the bacteria are club-shaped.

Stained Corynebacterium cells

Corynebacterium diphtheria diphtheria is caused by the toxin-producing bacterium called Corynebacterium diphtheriae. This organism, which lives in the mouth, nose, throat, or skin of an infected person and basically, in dark, wet places like the upper respiratory tracts, commonly affects the mucous membranes of the upper breathing passages, particularly the tonsils and the pharynx, which is the back of the mouth and the upper throat. The bacteria produce a toxin (poison), which enters the blood and is carried throughout the body. Infected individuals can easily pass the bacteria on to others through sneezing, coughing, or even laughing. It can also be spread to those who pick up tissues or drinking glasses that have been used by the infected person. People called carriers may harbor the bacteria without showing any signs of the disease. As a result, because they show no symptoms, they can easily spread the disease to others.

Symptoms appear about two to five days after infection, with the incubation period ranging from one to six days. Symptoms include a mild sore throat, fever, and swelling of the lymph nodes in the neck. A thick, grayish, tough, fibrous membrane forms on the surface of the tonsils and pharynx, and may even go as far up into the nose of down into the windpipe and lungs. This membrane can interfere with breathing or swallowing. In severe cases, this membrane can cause airway obstruction, which is the blocking of the breathing passages.

Diphtheria toxin can also affect the heart and nervous system. One serious effect is when toxin enters the bloodstream and the person may develop inflammation of the heart muscle called acute myocarditis. It is the most commonly seen and most worrisome complication, for it can result in permanent heart damage or in some cases, in which the toxin weakens the heart, death. Damage on the nervous system includes effects such as temporary paralysis of muscles in the throat and eyes, and most seriously, of the muscles used in breathing. Paralysis of the breathing muscles can be fatal.

In addition to all the other effects and damages; the diphtheria bacteria can also infect breaks in the skin. Such infections are called wound diphtheria or coetaneous diphtheria. In most cases of wound diphtheria, a membrane does not form over the infected area. However, when toxins enter the bloodstream, it can produce the same complications as those in the respiratory system. Patients who are not treated suffer a death rate of 40% to 50%.

Corynebacterium diphtheria diphtheria was once one the most common cause of death in children. During the late 1800s, diphtheria epidemics were rampant in the United States and Western Europe. At that time, most victims were under the age of ten. It was even widespread in the early 1900s, when all through the 1920s; the disease struck about 150,000 people a year, with 15,000 of them killed. However, since then, these numbers have dropped drastically. With the introduction and widespread use of diphtheria vaccine, diphtheria has been rare in the United States and Europe. There were only 918 cases in 1960, 435 in 1970, 128 in 1976, and 5 in 1991. Today, there are even fewer cases occurring each year. However, despite this great leap forward, diphtheria is still common in many parts of the world, including the Caribbean and Latin America. Outbreaks have been reported in Algeria, China and Ecuador. During the last few years, there was a serious outbreak of diphtheria in the separated states of the former USSR, with over 50,000 reported cases. The epidemic was caused because of a drop in the routine childhood immunizations (DPT) to less than 60% compliance.

Children and adults, infected with Corynebacterium diphtheria diphtheria are to be hospitalized. After a doctor confirms the diagnosis through throat culture and blood counts, the patient a special anti-toxin to neutralize the diphtheria toxin already circulating in the body. The patient also receives antibodies such as penicillin or erythromycin to kill the remaining diphtheria bacteria. The anti-toxin is given through injections or intravenously. The patient is watched closely while the anti-toxins are given because the solution, which is made of horse serum (blood), may cause an allergic reaction.

If the infection is advanced and severe, the patient may need mechanical assistance to breathe. If the toxins had spread top the heart, kidneys, or central nervous system, the patient may need intravenous fluids, oxygen, or cardiac medications. Furthermore, the patient must be isolated, for the disease is extremely contagious. Family members who have not been immunized or who are very young or elderly must be protected from any contact with the patient. Then, they will also receive antibiotics as a precaution.

Immediate hospitalization and early detection allows the patient to recover from diphtheria. After the antibiotics and anti-toxin are injected and working, the patient will be required to rest in bed for four to six weeks, or until full recovery. Bed rest is extremely important to a patient whose heart was affected by the disease.

In addition to the importance of treatment is prevention. There is a vaccine to prevent diphtheria from ever happening. The vaccine, which is called a DTP vaccine, also contains tetanus and pertussis vaccines. A child should receive four DTP shots by eighteen months of age, with a booster shot at age four to six. After that, diphtheria and tetanus boosters should be taken every ten years.

Although most children tolerate the vaccine well, the combined DTP vaccine sometimes causes mild side effects such as redness or tenderness at the injection site, a low fever, or mild crankiness. Although there are some severe complications such as an allergic reaction or seizures, they are extremely rare.

Bibliography
http://www2.adam.com/ency/article/002018.htm
http://www.ecbt.org/diphther.htm
http://health.yahoo.com/health/Disease-and-Conditions/Disease-Feed-Data/Diphtheria/
http://kidshealth.org/parent/common/diptheria.html

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