Diphtheria is an anthroponotic disease from the group of respiratory infections, caused by a toxigenic diphtheria bacillus. It is transmitted through airborne droplets and is characterized by various clinical forms, most often affecting the pharyngeal isthmus, with symptoms of intoxication and involvement of the cardiovascular and nervous systems.
Source of infection
The source of infection is a sick person with different forms of diphtheria, as well as carriers of the bacteria. Patients are contagious from the last day of the incubation period until complete recovery.
Carriers of diphtheria bacilli represent an even greater epidemiological risk, especially if they are present in non-immune communities.
Transmission
Diphtheria is transmitted through airborne droplets and airborne dust (aerosol), which are formed during coughing, sneezing, kissing, speaking, and by inhaling air containing dust particles contaminated with diphtheria bacilli. Toys, bed linen, clothing, and dishes may also become contaminated. A foodborne route is also possible through infected milk, creams, and other products.
The incubation period of diphtheria varies between 2 and 10 days. The disease may present in several clinical forms, depending on the site of infection.
Symptoms
- fever
- headache
- grayish-white membranes on the tonsils
- sore throat
- difficulty swallowing and breathing
Clinical forms
- pharyngeal
- nasal
- laryngeal
- tracheal
- bronchial
- cutaneous (rare)
- wound-related (rare)
- genital (rare)
Three stages are distinguished in the development of diphtheritic croup:
- catarrhal
- dysphonic
- stenotic or asphyxiating
Each stage has its own characteristic symptoms. It is important to note that the process can spread rapidly, and delayed medical care may lead to a fatal outcome.
Complications
- toxic myocarditis
- pneumonia
- heart damage
- encephalitis (rare)
- cranial nerve paralysis
- toxic nephrosis
- death
Anti-epidemic measures
In diphtheria outbreaks, early detection and isolation of patients in infectious disease wards is essential. Laboratory testing of contacts, disinfection measures, and investigation of contacts for diphtheria antibodies are required, followed by vaccination of non-immune individuals.
Carriers of toxigenic diphtheria bacilli are subject to the same preventive measures but can be isolated and treated at home, depending on the conditions.
Prevention
Patients with various forms of diphtheria are isolated and treated in infectious disease departments. Only vaccination coverage of at least 95% of the population can ensure disease eradication and interruption of transmission.
