What is Diphtheria?

Diphtheria is a very serious and contagious illness that significantly affects breathing. In some countries, like the US, cases of diphtheria are extremely rare because of vaccination. The diphtheria/pertussis/tetanus (DTP) vaccination is given soon after birth, with several booster shots administered in early childhood. Usually, children receive a last DTP booster shot at the age of 12 or 13. Adults may receive a booster if needed, as a booster vaccination is recommended for those traveling to areas where diphtheria is still common.

Initial symptoms of diphtheria present about three to five days after exposure to someone else with the germ. Transmission generally occurs by inhaling the droplets of an infected person's fluids. One’s presence around a person with diphtheria who is sneezing or coughing is usually enough to contract the disease.

Symptoms at first include fever and sore throat. One of the most dangerous aspects of the illness is the formation of a membrane over the throat, the nose, and into the bronchial tubes, which can significantly impact breathing. Swollen glands under the throat worsen breathing problems. Those with diphtheria often have a croup-like cough which cannot be resolved by exposure to night air.

As the membrane thickens over the throat, physicians may need to perform an intubation, or a tracheotomy to maintain an airway. People with diphtheria usually require hospitalization and administration of intravenous antibiotics in order to recover. To complicate matters, diphtheria may also affect the heart and cause serious cardiac damage. Diphtheria must also be treated with a medication called diphtheria anti-toxin to prevent such damage.

Given the contagiousness of the disease, any case of diphtheria in the US has to be reported to the Centers for Disease Control. The one exception is a relatively minor skin condition that can also be caused by the diphtheria bacterium. This can usually be resolved with oral antibiotics and does not progress to breathing difficulties.

Diphtheria used to claim the lives of thousands of children in the US and in Europe. It is still responsible for many deaths in countries where vaccination is not affordable. Most who die from diphtheria die because of insufficient airway-essentially they suffocate. The progress of this disease is painful to watch for parents who cannot afford treatment or vaccinations.

Development of sulfa drugs, which were followed by antibiotics, were the first steps toward finding a cure for a disease that in children often resulted in a 20% death rate. A successful vaccination was not created until after WWII.

Poorer countries frequently do not have the diphtheria vaccine available, causing periodic outbreaks that kill hundreds of children. Given the effectiveness of the vaccination and its relatively inexpensive cost, losing children to a now preventable disease is avoidable. Efforts to vaccinate those in countries where the vaccine remains too costly fall short of the need. Such an effort, many argue, is of great value, since vaccination could help eradicate diphtheria, and end needless loss of life.